Provider Demographics
NPI:1841053220
Name:RUIZ, ALYSSA YVETTE-LEAL (LCSW-S)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:YVETTE-LEAL
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 HENDRICK DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-4208
Mailing Address - Country:US
Mailing Address - Phone:214-681-6473
Mailing Address - Fax:
Practice Address - Street 1:11030 REEDER LN
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-6441
Practice Address - Country:US
Practice Address - Phone:469-387-6039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical