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Individual

TAMATHA RUTHERFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SPEECH-LANGUAGE PATH

Contact information

Practice address
610 3RD ST STE 200, MACON, GA 31201-3262
(478) 334-2328
Mailing address
610 3RD ST STE 200, MACON, GA 31201-3262
(478) 334-2328

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP003659
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
543788055A
GA
Enumeration date
01/17/2007
Last updated
07/21/2021
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