Provider Demographics
NPI:1912253899
Name:RUFF, RENEE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:RUFF
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7725 STARFIRE WAY
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-6345
Mailing Address - Country:US
Mailing Address - Phone:727-271-2933
Mailing Address - Fax:
Practice Address - Street 1:10401 WOODSTOCK RD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-5011
Practice Address - Country:US
Practice Address - Phone:813-920-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 11420235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist