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General NPI Number Information
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NPI Number | 1134948326
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Entity Type | Individual
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Provider Name | ISABEL RUTH RYZENGA LLMSW
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Gender | Female
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 3901 HIGHLAND RD STE C
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City | WATERFORD
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State | MI
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Zip | 48328-2162
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Country | US
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Telephone | 248-721-9335
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Fax |
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Provider Business Mailing Address
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Address Line | 23761 EASTERLING AVE
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City | HAZEL PARK
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State | MI
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Zip | 48030-1434
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Country | US
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Telephone | 616-594-8524
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851117410
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License Number State | MI
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