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General NPI Number Information
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NPI Number | 1841405578
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Entity Type | Individual
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Provider Name | ELLEN RUTH COHEN PHD MFT
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 719 2ND ST SUITE #4
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City | DAVIS
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State | CA
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Zip | 95616-4666
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Country | US
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Telephone | 530-756-9454
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Fax |
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Provider Business Mailing Address
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Address Line | 3496 OYSTER BAY AVE
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City | DAVIS
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State | CA
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Zip | 95616
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Country | US
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Telephone | 530-747-0602
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT022121
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License Number State | CA
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