Healthcare Provider Details

I. General information

NPI: 1336567247
Provider Name (Legal Business Name): RACHAEL MARIE RUTTER MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2014
Last Update Date: 03/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8575 W 110TH ST. SUITE 218
OVERLAND PARK KS
66210
US

IV. Provider business mailing address

8575 W 110TH ST. SUITE 218
OVERLAND PARK KS
66210
US

V. Phone/Fax

Practice location:
  • Phone: 913-345-0033
  • Fax:
Mailing address:
  • Phone: 913-345-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2561
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: