Basic Information
| Provider Information | |||||||||
| NPI: | 1982724423 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOTELO | ||||||||
| FirstName: | RUTH | ||||||||
| MiddleName: | AIMEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 362 N BEDFORD ST | ||||||||
| Address2: | |||||||||
| City: | EAST BRIDGEWATER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023331148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083502225 | ||||||||
| FaxNumber: | 5083502229 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 BRISTOL DR | ||||||||
| Address2: | |||||||||
| City: | SOUTH EASTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023751199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083502225 | ||||||||
| FaxNumber: | 5083502229 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 11/28/2016 | ||||||||
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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 | 101YM0800X | 116503 | MA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.