Individual
MS. RUTHANNE DOETZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 E FAIRMOUNT AVE, BALTIMORE, MD 21231-1534
(443) 923-9100
Mailing address
101 SPRINGSIDE DR, TIMONIUM, MD 21093-3444
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
06122
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06122
MARYLAND LIC. REG. CERT. NO.
MD
Enumeration date
09/15/2011
Last updated
09/15/2011
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