Provider Demographics
NPI:1912669714
Name:RUTHERFORD, ASHLEY (BSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05702-0222
Mailing Address - Country:US
Mailing Address - Phone:802-775-2381
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 222
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05702-0222
Practice Address - Country:US
Practice Address - Phone:802-775-2381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator