Provider Demographics
NPI:1588375240
Name:JAMES-DICKENS, RUTH
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:JAMES-DICKENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7706 BROOKHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-4018
Mailing Address - Country:US
Mailing Address - Phone:216-246-2044
Mailing Address - Fax:
Practice Address - Street 1:7706 BROOKHAVEN CT
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-4018
Practice Address - Country:US
Practice Address - Phone:216-246-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1097778222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty