Altis Beatrice Rutherford, BA,BHRS, CM-A

Individual provider Active NPI Counselor · Valliant, OK

NPI 1720118276 · NPPES record last updated Sep 22, 2011

Key facts

NPI
1720118276
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
300 N Dalton
Valliant, OK 74764
Phone
(580) 286-6638
Fax
(580) 286-5206
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts, Certified Medical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valliant House, LLC Past
since Mar 31, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Yes

Addresses

Primary practice location

300 N Dalton
Valliant, OK 74764

Mailing address

PO Box 673
Valliant, OK 74764-0673
Phone (580) 933-7031

Other names

  • Mrs. Altis Beatrice Rutherford Other name

Other providers in Valliant, OK

All providers in Valliant, OK · Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.