Provider Demographics
NPI:1912014895
Name:RUTLAND, EDWARD HERBERT (LMHC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:HERBERT
Last Name:RUTLAND
Suffix:
Gender:M
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E MILLER ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2123
Mailing Address - Country:US
Mailing Address - Phone:407-246-6620
Mailing Address - Fax:
Practice Address - Street 1:101 E MILLER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2123
Practice Address - Country:US
Practice Address - Phone:407-246-6620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3655101YM0800X
FL1567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist