MEDICARE: ROSALINA RUIZ LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	4846	TX
2	101YP2500X	Professional Counselor	64155	TX

General Provider Information

NPI Number	:	1013206333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSALINA RUIZ LPC

Provider Business Mailing Address
First Line	:	3249 MANNY AGUILERA DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2760
Country	:	US
Telephone Number	:	832-998-7387
Fax Number	:	832-200-3005

Provider Business Practice Location Address
First Line	:	3249 MANNY AGUILERA DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2760
Country	:	US
Telephone Number	:	832-998-7387
Fax Number	:	832-200-3005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2011
Last Update Date	:	01/13/2017

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Directions to “ ROSALINA RUIZ LPC” Practice Location

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