Provider Demographics
NPI:1942568241
Name:STONESTREET, RUTH HORNING (PHD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:HORNING
Last Name:STONESTREET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 N OAK ST BLDG B
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-5903
Mailing Address - Country:US
Mailing Address - Phone:229-219-7993
Mailing Address - Fax:229-219-7914
Practice Address - Street 1:2700 N OAK ST BLDG B
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-5903
Practice Address - Country:US
Practice Address - Phone:229-219-7993
Practice Address - Fax:229-219-7914
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3623235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist