Provider Demographics
NPI:1104957299
Name:RUHL, LINDA C (LICENSED MENTAL HEAL)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:C
Last Name:RUHL
Suffix:
Gender:F
Credentials:LICENSED MENTAL HEAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HART PLACE
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746
Mailing Address - Country:US
Mailing Address - Phone:631-242-5501
Mailing Address - Fax:631-242-5501
Practice Address - Street 1:7 HART PLACE
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746
Practice Address - Country:US
Practice Address - Phone:631-242-5501
Practice Address - Fax:631-242-5501
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000888101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health