Provider Demographics
NPI:1932122249
Name:KLOT, RUTH K (CRC, EDS, LMFT)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:K
Last Name:KLOT
Suffix:
Gender:F
Credentials:CRC, EDS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 NORTHERN PKWY
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1740
Mailing Address - Country:US
Mailing Address - Phone:201-447-2424
Mailing Address - Fax:
Practice Address - Street 1:527 NORTHERN PKWY
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1740
Practice Address - Country:US
Practice Address - Phone:201-447-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100127000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist