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Individual

MR. DEREK RUTTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCA, LCAS-A

Contact information

Practice address
631 WILLOW CREEK RD, LEICESTER, NC 28748-5646
(828) 318-0148
Mailing address
631 WILLOW CREEK RD, LEICESTER, NC 28748-5646
(828) 318-0148

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-21141
NC
101YP2500X
Professional Counselor
Primary
A11163
NC

Other

Enumeration date
08/21/2015
Last updated
08/21/2015
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