Provider Demographics
NPI:1538657382
Name:KRAVETS, RUSE MARIE
Entity Type:Individual
Prefix:
First Name:RUSE MARIE
Middle Name:
Last Name:KRAVETS
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 1:9542 FLORA ROCK LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5178
Mailing Address - Country:US
Mailing Address - Phone:917-525-6145
Mailing Address - Fax:
Practice Address - Street 1:67 S HIGLEY RD STE 103-477
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1166
Practice Address - Country:US
Practice Address - Phone:516-521-9349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist