Provider Demographics
NPI:1972933596
Name:RUIZ, DAMARYS I (CCC, SLP)
Entity Type:Individual
Prefix:
First Name:DAMARYS
Middle Name:I
Last Name:RUIZ
Suffix:
Gender:F
Credentials:CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FERROCARRIL 503
Mailing Address - Street 2:. URB SANTA MARIA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1111
Mailing Address - Country:US
Mailing Address - Phone:787-651-3720
Mailing Address - Fax:
Practice Address - Street 1:CALLE FERROCARRIL # 503
Practice Address - Street 2:URB. SANTA MARIA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1195
Practice Address - Country:US
Practice Address - Phone:787-651-3720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0458235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist