Healthcare Provider Details

I. General information

NPI: 1316379530
Provider Name (Legal Business Name): JOYCE MARIE KUCZMA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11639 ROUTE 30 STE 1113
NORTH HUNTINGDON PA
15642-5310
US

IV. Provider business mailing address

11639 ROUTE 30 STE 1113
NORTH HUNTINGDON PA
15642-5310
US

V. Phone/Fax

Practice location:
  • Phone: 412-628-1688
  • Fax:
Mailing address:
  • Phone: 412-628-1688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF000727
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: