Individual
DR. CHERYL ANN RUTHERFORD-NGOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6702 TREEHILLS PKWY, STONE MOUNTAIN, GA 30088-4605
(404) 914-1777
Mailing address
PO BOX 941692, ATLANTA, GA 31141-0692
(404) 914-1777
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
107031
GA
174400000X
Specialist
Primary
107031
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107031
GEORGIA PROFESSIONAL CERTIFICATION
GA
Enumeration date
07/23/2010
Last updated
12/17/2012
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