Provider Demographics
NPI:1992088983
Name:URRUTY, JANE
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:URRUTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WY
Mailing Address - Zip Code:82834-9339
Mailing Address - Country:US
Mailing Address - Phone:307-684-5921
Mailing Address - Fax:307-684-5921
Practice Address - Street 1:28 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WY
Practice Address - Zip Code:82834-9339
Practice Address - Country:US
Practice Address - Phone:307-684-5921
Practice Address - Fax:307-684-5921
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services