Healthcare Provider Details

I. General information

NPI: 1386534659
Provider Name (Legal Business Name): DAWN MARIE RUANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 N CHURCH ST UNIT 106
MOORESTOWN NJ
08057-1245
US

IV. Provider business mailing address

1221 N CHURCH ST UNIT 106
MOORESTOWN NJ
08057-1245
US

V. Phone/Fax

Practice location:
  • Phone: 856-359-4262
  • Fax:
Mailing address:
  • Phone: 856-359-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: