Provider Demographics
NPI:1053484436
Name:BLOW, RUBY (MA, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:RUBY
Middle Name:
Last Name:BLOW
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 NORTH DRUID HILLS RD NE
Mailing Address - Street 2:SUITES E & J
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3919
Mailing Address - Country:US
Mailing Address - Phone:404-642-3738
Mailing Address - Fax:404-248-1558
Practice Address - Street 1:2910 N DRUID HILLS RD NE
Practice Address - Street 2:SUITES E& J
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3919
Practice Address - Country:US
Practice Address - Phone:404-248-1557
Practice Address - Fax:404-248-1558
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003511101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional