Provider Demographics
NPI:1154537983
Name:RUIZ, MARTHA MARIA (LMHC)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:MARIA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9732 SW 24TH ST
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7598
Mailing Address - Country:US
Mailing Address - Phone:305-225-4432
Mailing Address - Fax:305-225-4456
Practice Address - Street 1:9732 SW 24TH ST
Practice Address - Street 2:SUITE # 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7598
Practice Address - Country:US
Practice Address - Phone:305-225-4432
Practice Address - Fax:305-225-4456
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3970101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health