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General NPI Number Information
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NPI Number | 1386061109
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Entity Type | Individual
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Provider Name | NANETH RUIZ LPC
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Gender | Female
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Dates
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Enumeration Date | 03/19/2014
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 2211 W MEADOWVIEW RD STE 112
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City | GREENSBORO
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State | NC
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Zip | 27407-3408
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Country | US
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Telephone | 336-252-3932
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Fax | 336-218-6808
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Provider Business Mailing Address
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Address Line | 2211 W MEADOWVIEW RD STE 112
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City | GREENSBORO
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State | NC
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Zip | 27407-3408
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Country | US
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Telephone | 336-252-3932
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Fax | 336-218-6808
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10744
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PC11066
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License Number State | NC
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