Provider Demographics
NPI:1538682778
Name:RUIZ-GARCIA, BRENDA LIZ (MSW, RMHC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:LIZ
Last Name:RUIZ-GARCIA
Suffix:
Gender:F
Credentials:MSW, RMHC
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:LIZ
Other - Last Name:CABALLERO-GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, RMHC
Mailing Address - Street 1:121 WEBB DRIVE SUITE 400
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837
Mailing Address - Country:US
Mailing Address - Phone:863-438-6806
Mailing Address - Fax:
Practice Address - Street 1:121 WEBB DRIVE SUITE 400
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837
Practice Address - Country:US
Practice Address - Phone:863-438-6806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health