Provider Demographics
NPI:1679831341
Name:PASTER DAVIS, RUTH LEAH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:LEAH
Last Name:PASTER DAVIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:LEAH
Other - Last Name:PASTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:40522 HAYES RD STE 600
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5904
Mailing Address - Country:US
Mailing Address - Phone:248-506-2179
Mailing Address - Fax:
Practice Address - Street 1:40522 HAYES RD STE 600
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5904
Practice Address - Country:US
Practice Address - Phone:248-506-2179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010872911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical