Provider Demographics
NPI:1073555355
Name:STINE, RUTH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:STINE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 KENILWORTH DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2140
Mailing Address - Country:US
Mailing Address - Phone:443-536-2395
Mailing Address - Fax:410-878-7433
Practice Address - Street 1:1107 KENILWORTH DR
Practice Address - Street 2:SUITE 208
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2140
Practice Address - Country:US
Practice Address - Phone:443-536-2395
Practice Address - Fax:410-878-7433
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04266103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist