Individual
TINA MARIE RUTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
22 MILLBRANCH RD STE 1200, HATTIESBURG, MS 39402-1594
(601) 255-5264
Mailing address
22 MILLBRANCH RD STE 1200, HATTIESBURG, MS 39402-1594
(601) 255-5264
(866) 625-0559
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
67415
MS
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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