Provider Demographics
NPI:1124225438
Name:DEIN, RUTH ANN (BSN, MA, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ANN
Last Name:DEIN
Suffix:
Gender:F
Credentials:BSN, MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 W HOUSTONIA AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-3992
Mailing Address - Country:US
Mailing Address - Phone:248-545-4767
Mailing Address - Fax:248-547-3490
Practice Address - Street 1:3577 W 13 MILE RD
Practice Address - Street 2:SUITE 404
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009320101Y00000X
MI4704098219163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No163WX0200XNursing Service ProvidersRegistered NurseOncology