Individual
JACEY RUISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 FORDHAM RD, ALLSTON, MA 02134-3000
(617) 782-6460
Mailing address
4400 VESTAL PKWY E, BINGHAMTON, NY 13902-4400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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