Provider Demographics
NPI:1154384923
Name:DAVIES SULSER, RUTH (PHD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:DAVIES SULSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JEFFERSON BARRACKS DR
Mailing Address - Street 2:MENTAL HEALTH 116/JB
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-4181
Mailing Address - Country:US
Mailing Address - Phone:314-894-6653
Mailing Address - Fax:314-894-5783
Practice Address - Street 1:1 JEFFERSON BARRACKS DR
Practice Address - Street 2:MENTAL HEALTH 116/JB
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4181
Practice Address - Country:US
Practice Address - Phone:314-894-6653
Practice Address - Fax:314-894-5783
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY 01441103TA0700X, 103TC0700X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation