Most Relevant Information
Provider Data
| NPI Number: | 1003267568 |
| Provider Name: | FELICE DE RUGGIERO LICSW, LADC-1 |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 12380 |
Most Important Dates
| Enumeration Date: | 06/27/2016 |
| Last Updated: | 06/27/2016 |
Provider Practice Location
365 EAST ST
TEWKSBURY
MA
018761950
Practice Location Phone/Fax
| Phone: | 9788635068 |
| Fax: | 9788635091 |
Provider Mailing Location
365 EAST ST
TEWKSBURY
MA
018761950
Provider Mailing Phone/Fax
| Phone: | 9788635068 |
| Fax: | 9788635091 |