Individual
DR. ANGELA M. CARRUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5350 LAMME RD, MORAINE, OH 45439-3215
(937) 534-4651
(937) 534-4609
Mailing address
2110 LEITER RD, MIAMISBURG, OH 45342-3660
(937) 914-7054
(937) 522-7685
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5483
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2859536
—
OH
Enumeration date
10/03/2006
Last updated
11/24/2020
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