MEDICARE: MS. RUTH ANN MYERS LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	89-0000055	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598790370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH ANN MYERS LICSW

Provider Business Mailing Address
First Line	:	940 WATER ST UNIT 9
Second Line	:
City	:	NORTH BENNINGTON
State	:	VT
Zip	:	05257-9814
Country	:	US
Telephone Number	:	802-753-1571
Fax Number	:	802-442-1200

Provider Business Practice Location Address
First Line	:	940 WATER ST UNIT 9
Second Line	:
City	:	NORTH BENNINGTON
State	:	VT
Zip	:	05257-9814
Country	:	US
Telephone Number	:	802-753-1571
Fax Number	:	802-442-1200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	12/14/2010

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