| Doctor Name: | CHANCEY MARIE RUIZ |
| NPI Number: | 1093184012 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCDC |
| License Number: | 13133 |
| Business Practice Address: | 2111 W Us Highway 377 Granbury, TX - 760485627 |
| Business Phone Number: | 8175736002 |
| Business Fax Number: | 8175736009 |
| Mailing Address: | 239 S Virginia St, STEPHENVILLE |
| State: | TX |
| Postal Code: | 764014344 |
| Phone Number: | 2549655515 |
| Fax Number: | 2549657416 |
| NPI Enumeration Date: | 09/21/2015 |
| NPI Last Update Date: | 09/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 13133 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |