Provider Demographics
NPI:1487271573
Name:ABRAHAM MENTOR, RUTH (MS COUNSELING PSY)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:
Last Name:ABRAHAM MENTOR
Suffix:
Gender:F
Credentials:MS COUNSELING PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 TORREY ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4855
Mailing Address - Country:US
Mailing Address - Phone:508-274-4383
Mailing Address - Fax:508-584-4328
Practice Address - Street 1:104 TORREY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4855
Practice Address - Country:US
Practice Address - Phone:508-274-4383
Practice Address - Fax:508-584-4328
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty