Provider Demographics
NPI:1780988568
Name:HINER, RUTH ANN (PSYS)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANN
Last Name:HINER
Suffix:
Gender:F
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27136 SHAGBARK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3535
Mailing Address - Country:US
Mailing Address - Phone:248-569-6241
Mailing Address - Fax:
Practice Address - Street 1:27136 SHAGBARK DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3535
Practice Address - Country:US
Practice Address - Phone:248-569-6241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013987103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical