Provider Demographics
NPI:1508425125
Name:RUIZ, HEIDI B (LPC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:B
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 S JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6672
Mailing Address - Country:US
Mailing Address - Phone:956-631-9000
Mailing Address - Fax:956-631-9013
Practice Address - Street 1:5420 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6672
Practice Address - Country:US
Practice Address - Phone:956-631-9000
Practice Address - Fax:956-631-9013
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76428101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional