Provider Demographics
NPI:1326839366
Name:RUIZ, FANNY (MS LPC-A)
Entity type:Individual
Prefix:
First Name:FANNY
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MS LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-2851
Mailing Address - Country:US
Mailing Address - Phone:956-400-3291
Mailing Address - Fax:
Practice Address - Street 1:909 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78573-2851
Practice Address - Country:US
Practice Address - Phone:956-400-3291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97874101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional