Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 97993 | DE |
NPI | 1093378036 |
---|---|
Provider Name | Melonie Ruiz |
First Address | National Park, NJ 08063-1123 |
Second Address | Bear, DE 19701-1323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2019 |
Last Update Date | 16/04/2019 |