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NPI Code Detail

MEDICARE: MRS. RUTH RODDY

MEDICARE: MRS. RUTH RODDY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor74933TX

General Provider Information

NPI Number : 1780094383
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RUTH RODDY
Provider Business Mailing Address
First Line : 6401 ELDORADO PKWY STE 333
Second Line :
City : MCKINNEY
State : TX
Zip : 75070-6520
Country : US
Telephone Number : 972-200-0669
Fax Number :
Provider Business Practice Location Address
First Line : 700 E PARK BLVD STE 206
Second Line :
City : PLANO
State : TX
Zip : 75074-5472
Country : US
Telephone Number : 972-200-0669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2014
Last Update Date : 02/18/2020

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