Provider Demographics
NPI:1366982530
Name:RUTTINGER, KAYLA MARIE
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:MARIE
Last Name:RUTTINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KAYLA
Other - Middle Name:MARIE
Other - Last Name:RUTTINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:509 HERRICK PARK DR
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-1429
Mailing Address - Country:US
Mailing Address - Phone:515-403-8784
Mailing Address - Fax:
Practice Address - Street 1:215 E BIG BEAVER RD STE 100
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1216
Practice Address - Country:US
Practice Address - Phone:515-403-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)