Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 6108 | MA |
N | 2251G0304X | Physical Therapist - Geriatrics | 3232 | MA |
NPI | 1124174784 |
---|---|
Provider Name | Dr. Theresa E Ruby |
First Address | Taunton, MA 02780-4374 |
Second Address | Taunton, MA 02780-4374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 08/07/2007 |