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General NPI Number Information
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NPI Number | 1972930139
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Entity Type | Individual
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Provider Name | JOSEPHINE ANNE CARUSO-RUHL MA, LLP
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Gender | Female
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 670 GRISWOLD ST STE. #3
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City | NORTHVILLE
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State | MI
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Zip | 48167-2675
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Country | US
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Telephone | 248-347-3470
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Fax |
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Provider Business Mailing Address
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Address Line | 23871 WINGED FOOT WAY
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City | SOUTH LYON
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State | MI
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Zip | 48178-9083
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Country | US
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Telephone | 248-514-7713
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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 | 6301009864
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License Number State | MI
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