Provider Demographics
NPI:1033487616
Name:GOLDMAN, RUTH H
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:H
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 CONNECTICUT AVE NW APT 308
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5703
Mailing Address - Country:US
Mailing Address - Phone:202-364-4208
Mailing Address - Fax:202-362-2692
Practice Address - Street 1:4600 CONNECTICUT AVE NW APT 308
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5703
Practice Address - Country:US
Practice Address - Phone:202-364-4208
Practice Address - Fax:202-362-2692
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3008741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical