Provider Demographics
NPI:1053118992
Name:AMATE, RUTH OTUKO ANIM
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:OTUKO ANIM
Last Name:AMATE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 VERNON ST APT 417S
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01607-1159
Mailing Address - Country:US
Mailing Address - Phone:774-548-0990
Mailing Address - Fax:
Practice Address - Street 1:200 VERNON ST APT 417S
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01607-1159
Practice Address - Country:US
Practice Address - Phone:774-548-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst