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General NPI Number Information
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NPI Number | 1861750309
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Entity Type | Individual
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Provider Name | NEISHMA RASSEL RUIZ PSYD.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2012
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Last Update Date | 05/02/2012
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Provider Practice Location Address
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Address Line | JARDIN CENTRAL A-1 BO MARIANA
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City | HUMACAO
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State | PR
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Zip | 00792
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Country | US
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Telephone | 787-242-9307
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10006 CUH STATION
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City | HUMACAO
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State | PR
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Zip | 00792-1120
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Country | US
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Telephone | 178-724-2930
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4201
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License Number State | PR
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