Individual
JASON A RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 UNION ST, SUITE 557, LAWRENCE, MA 01840-1866
(978) 651-2551
Mailing address
42 CRESTWOOD CIR, LAWRENCE, MA 01843-1951
(978) 651-2551
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
S12281707
MA
103T00000X
Psychologist
S12281707
MA
104100000X
Social Worker
S12281707
MA
Other
Enumeration date
04/05/2012
Last updated
04/05/2012
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