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General NPI Number Information
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NPI Number | 1952191728
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Entity Type | Individual
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Provider Name | CRISTINA RUIZ-STEPHENS PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 455 PHILIP BLVD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8767
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Country | US
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Telephone | 678-225-0350
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Fax |
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Provider Business Mailing Address
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Address Line | 2345 MORGAN FARM DR
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City | BUFORD
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State | GA
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Zip | 30519-3044
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Country | US
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Telephone | 203-558-9080
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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 | 8771253
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License Number State | ID
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