Provider Demographics
NPI:1669831772
Name:GERMAINE, RUTH ANN
Entity Type:Individual
Prefix:
First Name:RUTH ANN
Middle Name:
Last Name:GERMAINE
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 1:52 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02779-1509
Mailing Address - Country:US
Mailing Address - Phone:774-226-3873
Mailing Address - Fax:
Practice Address - Street 1:52 GREEN ST
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MA
Practice Address - Zip Code:02779-1509
Practice Address - Country:US
Practice Address - Phone:774-226-3873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker