Healthcare Provider Details

I. General information

NPI: 1861819757
Provider Name (Legal Business Name): RUTH E PLANADEBALL PH. D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

K2 CALLE 4
RIO GRANDE PR
00745-2823
US

IV. Provider business mailing address

K2 CALLE 4
RIO GRANDE PR
00745-2823
US

V. Phone/Fax

Practice location:
  • Phone: 787-688-1735
  • Fax:
Mailing address:
  • Phone: 787-688-1735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number5370
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: