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General NPI Number Information
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NPI Number | 1023349495
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Entity Type | Individual
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Provider Name | SANDRA RUIZ MA
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Gender | Female
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Dates
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Enumeration Date | 01/24/2010
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Last Update Date | 01/24/2010
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Provider Practice Location Address
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Address Line | HC 1 BOX 8811 BO. MONTOSO
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City | MARICAO
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State | PR
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Zip | 00606-9408
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Country | US
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Telephone | 787-314-1528
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 8811 BO. MONTOSO
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City | MARICAO
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State | PR
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Zip | 00606-9408
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Country | US
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Telephone | 787-314-1528
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1611
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License Number State | PR
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