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General NPI Number Information
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NPI Number | 1982253639
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Entity Type | Individual
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Provider Name | KAYA ROSE RUCCI MHC-P
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 8175 SHERIDAN DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6095
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Country | US
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Telephone | 716-906-3770
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Fax |
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Provider Business Mailing Address
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Address Line | 56 BROOK LN
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City | WEST SENECA
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State | NY
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Zip | 14224-3866
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Country | US
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Telephone | 716-868-5292
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P100219
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License Number State | NY
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