Provider Demographics
NPI:1548589351
Name:RUFFIN, ROSALYN ANN (LMFT)
Entity type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:ANN
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515A S FRY RD # 306
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2214
Mailing Address - Country:US
Mailing Address - Phone:713-480-3534
Mailing Address - Fax:281-398-1452
Practice Address - Street 1:515 A SOUTH FRY RD
Practice Address - Street 2:ROSALYN RUFFIN
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450
Practice Address - Country:US
Practice Address - Phone:713-480-3534
Practice Address - Fax:281-398-1452
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TA0400X, 101YM0800X, 103TB0200X
TX4510252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral