Individual
MR. DEREK RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRC, LPC
Contact information
Practice address
49 KESSEL CT, MADISON, WI 53711-6275
(608) 280-2636
Mailing address
25 KESSEL CT, MADISON, WI 53711-6227
(608) 280-2636
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178010196
IL
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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