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Individual

JENNIFER RUTALIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9607 KINCEY AVE, HUNTERSVILLE, NC 28078-9140
(704) 686-7904
Mailing address
9607 KINCEY AVE, HUNTERSVILLE, NC 28078-9140
(704) 686-7904

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
158
NC
103K00000X
Behavior Analyst
158
106S00000X
Behavior Technician
1-17-44457
NC

Other

Enumeration date
03/20/2019
Last updated
10/09/2024
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