Individual
KELLY RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS-CCC-SLP
Contact information
Practice address
1 JOHN MARSHALL DRIVE, HUNTINGTON, WV 25701
(304) 696-3641
(304) 696-2986
Mailing address
1 JOHN MARSHALL DRIVE, HUNTINGTON, WV 25701
(304) 696-3641
(304) 696-2986
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0949
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006433
—
WV
Enumeration date
12/06/2006
Last updated
11/17/2021
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