Healthcare Provider Details

I. General information

NPI: 1730178039
Provider Name (Legal Business Name): RUTH H HABLAS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MORRILL PLACE LEVEL ONE
AMESBURY MA
01913-0008
US

IV. Provider business mailing address

PO BOX 326 RUTH H HABLAS PHD
AMESBURY MA
01913-0008
US

V. Phone/Fax

Practice location:
  • Phone: 978-388-5939
  • Fax:
Mailing address:
  • Phone: 978-388-5939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3740
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: