MEDICARE: MELISSA MARENUS RUIZ ED.S

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	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1992520993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MARENUS RUIZ ED.S

Provider Business Mailing Address
First Line	:	7605 ROYAL DOMINION DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-4664
Country	:	US
Telephone Number	:	610-295-7914
Fax Number	:

Provider Business Practice Location Address
First Line	:	7605 ROYAL DOMINION DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-4664
Country	:	US
Telephone Number	:	610-295-7914
Fax Number	:

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

Provider Enumeration Date	:	11/15/2024
Last Update Date	:	11/15/2024

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