Individual
RUTHANNE TAGGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CADC
Contact information
Practice address
51 MARKET ST, BANGOR, PA 18013-1901
(610) 588-9109
Mailing address
416 WOOD ST, PEN ARGYL, PA 18072-1364
(610) 881-4153
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12959
PA
Other
Enumeration date
12/15/2019
Last updated
12/15/2019
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