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General NPI Number Information
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NPI Number | 1083210843
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Entity Type | Organization
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Legal Business Name | CARRUTHERS THERAPY LLC
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 1675 84TH ST SE
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City | CALEDONIA
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State | MI
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Zip | 49316-7939
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Country | US
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Telephone | 616-238-0159
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 ROYAL OAK ST SW
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City | WYOMING
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State | MI
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Zip | 49509-3562
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | DR. KATHY A CARRUTHERS
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Credential | DSW, LMSW
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Telephone | 616-238-0159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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