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Individual

AMY RUTHERFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M. ED., LPC

Contact information

Practice address
3131 EXECUTIVE DR, SAN ANGELO, TX 76904-6801
(325) 947-5021
(325) 267-2629
Mailing address
3131 EXECUTIVE DR, SAN ANGELO, TX 76904-6801
(325) 947-5021
(325) 267-2629

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
84390
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
84390
LICENSED PROFESSIONAL COUNSELOR
TX
Enumeration date
02/22/2023
Last updated
07/06/2024
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