Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 093 | ME |
NPI | 1083929426 |
---|---|
Provider Name | Kimberly G. Rutherford |
First Address | Saco, ME 04072-2812 |
Second Address | Saco, ME 04072-2812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2010 |
Last Update Date | 10/08/2010 |