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Individual

KATHLEEN JO RUTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSCSW

Contact information

Practice address
901 S HOLYOKE ST, BUILDING G SUITE 100, WICHITA, KS 67218-2928
(316) 636-2888
(316) 636-2366
Mailing address
901 S HOLYOKE ST, BUILDING G SUITE 100, WICHITA, KS 67218-2928
(316) 636-2888
(316) 636-2366

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSCSW 1865
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
069381
BCBS OF KANSAS
KS
01
4463
PPK
KS
01
A008
TRIWEST
KS
Enumeration date
08/13/2006
Last updated
02/08/2017
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