Doctor Name: | MS. RITA DE BRUYNE |
NPI Number: | 1083810337 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 000195 |
Business Practice Address: | 31 Bailey Ave Ridgefield, CT - 068774533 |
Business Phone Number: | 2034387591 |
Business Fax Number: | 2034310855 |
Mailing Address: | 19 Cook Close, RIDGEFIELD |
State: | CT |
Postal Code: | 068773915 |
Phone Number: | 2034387591 |
Fax Number: | 2034310955 |
NPI Enumeration Date: | 06/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 000195 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |