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General NPI Number Information
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NPI Number | 1154383966
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Entity Type | Individual
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Provider Name | REBECCA RUTH LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 777 TREY CT
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City | APOPKA
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State | FL
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Zip | 32712-1749
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Country | US
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Telephone | 407-462-8681
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Fax | 407-886-1004
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Provider Business Mailing Address
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Address Line | 777 TREY CT
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City | APOPKA
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State | FL
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Zip | 32712-1749
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Country | US
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Telephone | 407-462-8681
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Fax | 407-886-1004
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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 | SW 5484
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License Number State | FL
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