Provider Demographics
NPI:1285962712
Name:RUTH, EMILY BARR (PSYD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:BARR
Last Name:RUTH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2696 COMPASS PLANT BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-4696
Mailing Address - Country:US
Mailing Address - Phone:608-318-1051
Mailing Address - Fax:
Practice Address - Street 1:702 N BLACKHAWK AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3357
Practice Address - Country:US
Practice Address - Phone:608-698-0201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2804-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical