Provider Demographics
NPI:1447623145
Name:RUFFIN, KARTANYA
Entity type:Individual
Prefix:MRS
First Name:KARTANYA
Middle Name:
Last Name:RUFFIN
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 1:315 S COLLEGE RD
Mailing Address - Street 2:SUITE NUMBER 100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3212
Mailing Address - Country:US
Mailing Address - Phone:337-205-6073
Mailing Address - Fax:337-264-9282
Practice Address - Street 1:315 S COLLEGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3212
Practice Address - Country:US
Practice Address - Phone:337-205-6073
Practice Address - Fax:337-264-9282
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health