Provider Demographics
NPI:1932679651
Name:RUE, ELIZABETH TOOSEE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:TOOSEE
Last Name:RUE
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 1:24 SEAVER ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02121-1513
Mailing Address - Country:US
Mailing Address - Phone:701-799-7036
Mailing Address - Fax:
Practice Address - Street 1:24 SEAVER ST APT 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02121-1513
Practice Address - Country:US
Practice Address - Phone:701-799-7036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherN/A