Individual
LESLIE C RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
445 S LANDMARK AVE, BLOOMINGTON, IN 47403-5004
(812) 322-8802
Mailing address
1900 W 3RD ST, SPENCER PSYCHOLOGY, BLOOMINGTON, IN 47404-5209
(812) 333-8474
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33006519A
IN
1041C0700X
Clinical Social Worker
Primary
34007157A
IN
Other
Enumeration date
12/04/2012
Last updated
04/16/2018
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