Provider Demographics
NPI:1083731814
Name:RICH, RUTH KRIGBAUM (PSYD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:KRIGBAUM
Last Name:RICH
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 1:3 ESSEX GREEN DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2927
Mailing Address - Country:US
Mailing Address - Phone:978-532-6565
Mailing Address - Fax:978-532-6366
Practice Address - Street 1:3 ESSEX GREEN DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2927
Practice Address - Country:US
Practice Address - Phone:978-532-6565
Practice Address - Fax:978-532-6366
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6513103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05207Medicare ID - Type Unspecified