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General NPI Number Information
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NPI Number | 1497568232
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Entity Type | Organization
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Legal Business Name | RUTH PATTON PLLC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 3317 E CHASEWOOD DR
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City | AMMON
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State | ID
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Zip | 83406-4007
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Country | US
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Telephone | 651-319-1466
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 S HIGHLINE DR
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City | IDAHO FALLS
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State | ID
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Zip | 83401-5909
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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
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Name | RUTH PATTON
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Credential | LCSW
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Telephone | 651-319-1466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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