MEDICARE: RUTH OLMSTEAD PH.D.

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
1	101YM0800X	Mental Health Counselor	MH10613	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700182987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH OLMSTEAD PH.D.

Provider Business Mailing Address
First Line	:	137 GOLDEN ISLES DR
Second Line	:	#706
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-5886
Country	:	US
Telephone Number	:	954-296-8341
Fax Number	:

Provider Business Practice Location Address
First Line	:	137 GOLDEN ISLES DR
Second Line	:	#706
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-5886
Country	:	US
Telephone Number	:	954-296-8341
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2011
Last Update Date	:	02/04/2011

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