Individual
DR. LISA MARIE RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2620 N WALNUT ST STE 905, BLOOMINGTON, IN 47404-2008
(812) 508-6132
Mailing address
2620 N WALNUT ST STE 905, BLOOMINGTON, IN 47404-2008
(812) 269-6163
(765) 202-7275
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01079413A
IN
2084P0804X
Child & Adolescent Psychiatry Physician
01079413A
IN
Other
Enumeration date
04/10/2010
Last updated
08/06/2021
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