Individual
MR. IRWIN CLYDE RUTHERFORD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
109 OSIGIAN BLVD STE 400, WARNER ROBINS, GA 31088-8925
(229) 401-8431
Mailing address
133 KENTSHIRE LANE, BONAIRE, GA 31005
(229) 401-8431
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008881
GA
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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