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Individual

MS. BRANDIS L RUISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
3168 PEPPERTREE DR, MIDDLEBURG, FL 32068-8200
(352) 359-4092
Mailing address
3168 PEPPERTREE DR, MIDDLEBURG, FL 32068-8200
(352) 359-4092

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0133000643
VA
103K00000X
Behavior Analyst
1-12-10359
MD
103K00000X
Behavior Analyst
LBA066
MD
103TC0700X
Clinical Psychologist
0810007282
VA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810007282
VA

Other

Enumeration date
03/07/2012
Last updated
10/14/2021
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