Individual
KAITLYN NICOLE RUTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
650 W LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-2681
(270) 352-1132
Mailing address
645 BROADWAY ST APT 5, BRANDENBURG, KY 40108-1763
(502) 644-9299
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
RBT-18-63620
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-63620
BACB
KY
Enumeration date
08/30/2018
Last updated
08/30/2018
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