Provider Demographics
NPI:1639621089
Name:RUTH ANAN, PHD, PLLC
Entity Type:Organization
Organization Name:RUTH ANAN, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:MCLEISTER
Authorized Official - Last Name:ANAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-207-4107
Mailing Address - Street 1:25691 STRATH HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-2342
Mailing Address - Country:US
Mailing Address - Phone:248-207-4107
Mailing Address - Fax:
Practice Address - Street 1:27780 NOVI RD
Practice Address - Street 2:SUITE 107
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3401
Practice Address - Country:US
Practice Address - Phone:248-567-2930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010252103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty