Provider Demographics
NPI:1386105054
Name:RUANTO, RONALD REYES (MAS-MFT, LAMFT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:REYES
Last Name:RUANTO
Suffix:
Gender:M
Credentials:MAS-MFT, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 W SOUTHERN AVE APT 2051
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-5052
Mailing Address - Country:US
Mailing Address - Phone:480-406-3444
Mailing Address - Fax:
Practice Address - Street 1:1655 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8169
Practice Address - Country:US
Practice Address - Phone:480-969-6955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-10616106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist