Provider Demographics
NPI:1255813994
Name:BORIS, RUTH ANN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:BORIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MERIT DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1457
Mailing Address - Country:US
Mailing Address - Phone:216-261-9600
Mailing Address - Fax:866-565-9511
Practice Address - Street 1:3 MERIT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1457
Practice Address - Country:US
Practice Address - Phone:216-261-9600
Practice Address - Fax:866-565-9511
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-4382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist