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Individual

KATIE RUTHERFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMAC, LMSW

Contact information

Practice address
130 E 5TH ST, NEWTON, KS 67114-2206
(316) 283-6743
Mailing address
130 E 5TH ST, NEWTON, KS 67114-2206
(316) 283-6743

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
938
KS
104100000X
Social Worker
9783
KS

Other

Enumeration date
09/09/2021
Last updated
09/09/2021
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