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NPI Code Detail

MEDICARE: JULIET RUIZ LCSW, CT, MA

MEDICARE:   JULIET  RUIZ  LCSW, CT, MA
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
11041C0700XClinical Social Worker6770-CNV

General Provider Information

NPI Number : 1194096412
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIET RUIZ LCSW, CT, MA
Provider Business Mailing Address
First Line : 11141 SCOTSCRAIG CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89141-4333
Country : US
Telephone Number : 702-266-6150
Fax Number : 702-233-8472
Provider Business Practice Location Address
First Line : 6867 W CHARLESTON BLVD STE B
Second Line : SUITE B
City : LAS VEGAS
State : NV
Zip : 89117-1669
Country : US
Telephone Number : 702-266-6150
Fax Number : 702-233-8472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2012
Last Update Date : 10/21/2016

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