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General NPI Number Information
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NPI Number | 1588013635
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Entity Type | Organization
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Legal Business Name | CONSEJERIA RUIZ, PLLC
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 1451 S ELM EUGENE ST
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City | GREENSBORO
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State | NC
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Zip | 27406-2200
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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 | 1451 S ELM EUGENE ST
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City | GREENSBORO
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State | NC
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Zip | 27406-2200
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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 | CEO/OWNER
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Name | NANETH RUIZ
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Credential | LPC
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Telephone | 336-252-3932
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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 | PC11066
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License Number State | NC
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