Provider Demographics
NPI:1669263125
Name:RUIZ, LORETO ALEJANDRA (MT)
Entity type:Individual
Prefix:MS
First Name:LORETO
Middle Name:ALEJANDRA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 WEST ST APT 19
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-9784
Mailing Address - Country:US
Mailing Address - Phone:617-997-5748
Mailing Address - Fax:
Practice Address - Street 1:409 MAIN ST STE 253
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2346
Practice Address - Country:US
Practice Address - Phone:617-997-5748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11512225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist