Individual
BERNICE LEA FEDESTIN RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 WARREN ST, BRIGHTON, MA 02135-3602
(617) 254-3800
Mailing address
356 MAPLE ST, LYNN, MA 01904-3014
(617) 454-4751
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
123153
MA
Other
Enumeration date
09/16/2014
Last updated
10/19/2023
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