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General NPI Number Information
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NPI Number | 1669265104
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Entity Type | Individual
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Provider Name | NICOLE KRISTINE RUELA LSW
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1 W MAIN ST
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City | FLEETWOOD
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State | PA
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Zip | 19522-1350
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Country | US
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Telephone | 610-944-0445
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Fax | 610-944-8834
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Provider Business Mailing Address
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Address Line | 215 ADAMS DR
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City | WOMELSDORF
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State | PA
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Zip | 19567-1423
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Country | US
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Telephone | 610-297-1594
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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 | SW142732
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License Number State | PA
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