Provider Demographics
NPI:1366096919
Name:GODIER-RUESS, VIOLETTE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:VIOLETTE
Middle Name:
Last Name:GODIER-RUESS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 BRANCH AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2203
Mailing Address - Country:US
Mailing Address - Phone:732-290-5158
Mailing Address - Fax:
Practice Address - Street 1:73 BRANCH AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2203
Practice Address - Country:US
Practice Address - Phone:732-290-5158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00700700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty