Provider Demographics
NPI:1669426136
Name:RUTTER, BARBARA ALZORA (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ALZORA
Last Name:RUTTER
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 1:46-122 KIOWAI ST
Mailing Address - Street 2:UNIT 2811
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3698
Mailing Address - Country:US
Mailing Address - Phone:808-234-1153
Mailing Address - Fax:808-234-1153
Practice Address - Street 1:45-955 KAMEHAMEHA HWY
Practice Address - Street 2:SUITE 402
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3222
Practice Address - Country:US
Practice Address - Phone:808-741-1382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 316103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical