Individual
DANIELLE LAUREN RUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., NCC
Contact information
Practice address
538 ADAMS RD, FAYETTEVILLE, GA 30214-4107
(678) 429-4225
Mailing address
538 ADAMS RD, FAYETTEVILLE, GA 30214-4107
(678) 429-4225
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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