Individual
RUTH M HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TCADC
Contact information
Practice address
601 FOREST AVE, DES MOINES, IA 50314-2828
(515) 288-4742
Mailing address
601 FOREST AVE, DES MOINES, IA 50314-2828
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T20003
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T20003
—
IA
Enumeration date
01/09/2020
Last updated
01/09/2020
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