Provider Demographics
NPI:1790248243
Name:MOTE, RUTH
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:MOTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:MOTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, ALC
Mailing Address - Street 1:19000 OAK RD W UNIT 6200
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-5675
Mailing Address - Country:US
Mailing Address - Phone:251-284-4188
Mailing Address - Fax:
Practice Address - Street 1:815 N MCKENZIE ST STE A
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-3527
Practice Address - Country:US
Practice Address - Phone:251-284-4188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC4054A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health