Provider Demographics
NPI:1639436884
Name:RUIZ, ANA MARIA (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:MARIA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GIBRALTAR #2108 LA RAMBLA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4083
Mailing Address - Country:US
Mailing Address - Phone:787-449-7396
Mailing Address - Fax:
Practice Address - Street 1:2108 CALLE GIBRALTAR
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-4083
Practice Address - Country:US
Practice Address - Phone:787-449-7396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4042103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical