Individual
DR. MARY RUVEN STOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LCSW
Contact information
Practice address
4423 LEISURE TIME DR # C, DIAMONDHEAD, MS 39525-3221
(504) 616-6097
Mailing address
PO BOX 1144, KILN, MS 39556-1144
(504) 616-6097
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C2936
MS
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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