Provider Demographics
NPI:1962730697
Name:BRESEE, RUTH (LCSW)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:BRESEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24727 ROUTE 6
Mailing Address - Street 2:SUITE2
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-8257
Mailing Address - Country:US
Mailing Address - Phone:570-265-0100
Mailing Address - Fax:570-265-0100
Practice Address - Street 1:24727 ROUTE 6
Practice Address - Street 2:SUITE2
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-8257
Practice Address - Country:US
Practice Address - Phone:570-265-0100
Practice Address - Fax:570-265-0100
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0177741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical