Basic Information
| Provider Information | |||||||||
| NPI: | 1770862013 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUETZ | ||||||||
| FirstName: | JULIA | ||||||||
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| Credential: | PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8970 | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436230970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194754449 | ||||||||
| FaxNumber: | 4194793832 | ||||||||
| Practice Location | |||||||||
| Address1: | 5151 MONROE ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436233466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194754449 | ||||||||
| FaxNumber: | 4194793832 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2011 | ||||||||
| LastUpdateDate: | 08/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E.0900405-SUPV | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.