MEDICARE: DR. RUTH E. KHOWAIS PSY.D.

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	103T00000X	Psychologist	8247	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750410403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH E. KHOWAIS PSY.D.

Provider Business Mailing Address
First Line	:	35 BRAINTREE HILL PARK
Second Line	:	SUITE 100
City	:	BRAINTREE
State	:	MA
Zip	:	02184-8703
Country	:	US
Telephone Number	:	781-843-8887
Fax Number	:	781-843-3179

Provider Business Practice Location Address
First Line	:	1419 HANCOCK ST
Second Line	:	SUITE 302
City	:	QUINCY
State	:	MA
Zip	:	02169-5250
Country	:	US
Telephone Number	:	781-843-8887
Fax Number	:	781-843-3179

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

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