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General NPI Number Information
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NPI Number | 1306184247
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Entity Type | Organization
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Legal Business Name | RUTH E LEWIS PHD LLC
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | 742 MASSACHUSETTS AVE
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City | ARLINGTON
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State | MA
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Zip | 02476-4712
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Country | US
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Telephone | 781-483-3329
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Fax | 855-893-1289
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Provider Business Mailing Address
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Address Line | 742 MASSACHUSETTS AVE
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City | ARLINGTON
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State | MA
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Zip | 02476-4712
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Country | US
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Telephone | 781-483-3329
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Fax | 855-893-1289
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Authorized Official
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Title or Position | CLINICAL PYSCHOLOGIST
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Name | RUTH ELLEN LEWIS
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Credential | PHD
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Telephone | 781-483-3329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 7359
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License Number State | MA
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