Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
N | 225XM0800X | Mental Health | ||
Y | 225XM0800X | Mental Health | C.2002669 | OH |
NPI | 1538630975 |
---|---|
Provider Name | Wendy Rutledge |
First Address | Dayton, OH 45415-3154 |
Second Address | Dayton, OH 45415-3154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2018 |
Last Update Date | 05/06/2020 |