Healthcare Provider Details

I. General information

NPI: 1952044059
Provider Name (Legal Business Name): MRS. DELORA RUFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 8TH AVE S
NASHVILLE TN
37203-4139
US

IV. Provider business mailing address

2711 FOSTER AVE
NASHVILLE TN
37210-5307
US

V. Phone/Fax

Practice location:
  • Phone: 615-227-3000
  • Fax:
Mailing address:
  • Phone: 615-227-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6935
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: