Provider Demographics
NPI:1831999267
Name:RUTH, KERI LYNNE
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:LYNNE
Last Name:RUTH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-3319
Mailing Address - Country:US
Mailing Address - Phone:617-257-2661
Mailing Address - Fax:
Practice Address - Street 1:123 RIVER ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-3319
Practice Address - Country:US
Practice Address - Phone:617-257-2661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician