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General NPI Number Information
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NPI Number | 1942906375
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Entity Type | Individual
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Provider Name | MADISON RUTH BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 2441 S HIGHWAY 27
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City | SOMERSET
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State | KY
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Zip | 42501-2935
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Country | US
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Telephone | 606-677-4068
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Fax | 606-678-0872
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Provider Business Mailing Address
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Address Line | 122 SOMERHILL DR
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City | SOMERSET
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State | KY
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Zip | 42503-3474
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Country | US
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Telephone | 502-836-9011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 295928
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License Number State | KY
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