Provider Demographics
NPI:1437695822
Name:WOODWARD-RUGGERIO, YASMINE
Entity Type:Individual
Prefix:
First Name:YASMINE
Middle Name:
Last Name:WOODWARD-RUGGERIO
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 1:605 TURNER AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-1329
Mailing Address - Country:US
Mailing Address - Phone:503-347-8302
Mailing Address - Fax:
Practice Address - Street 1:605 TURNER AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-1329
Practice Address - Country:US
Practice Address - Phone:503-347-8302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician