Most Relevant Information
Provider Data
| NPI Number: | 1003458076 |
| Provider Name: | KATIE BETH RUDD |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/11/2019 |
| Last Updated: | 10/11/2019 |
Provider Practice Location
915 HIGHWAY 84 W
CARUTHERSVILLE
MO
638308113
Practice Location Phone/Fax
| Phone: | 5733335875 |
| Fax: |
Provider Mailing Location
915 HIGHWAY 84 W
CARUTHERSVILLE
MO
638308113
Provider Mailing Phone/Fax
| Phone: | 5733335875 |
| Fax: |