| Doctor Name: | LARRY RICHARD RUIZ |
| NPI Number: | 1063877546 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CSAC |
| License Number: | 1233-05 |
| Business Practice Address: | 1787 Wili Pa Loop Ste 7 Wailuku, HI - 967931271 |
| Business Phone Number: | 8082830737 |
| Business Fax Number: | |
| Mailing Address: | Po Box 81690, HAIKU |
| State: | HI |
| Postal Code: | 967081690 |
| Phone Number: | 8082830737 |
| Fax Number: | |
| NPI Enumeration Date: | 12/28/2015 |
| NPI Last Update Date: | 12/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1233-05 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |