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NPI Code Detail

MEDICARE: MARY B KOCH RUIZ LPC

MEDICARE:   MARY B KOCH RUIZ  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorPC001770PA

General Provider Information

NPI Number : 1255461927
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY B KOCH RUIZ LPC
Provider Business Mailing Address
First Line : 1630 LIME HOLLOW RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15235-1859
Country : US
Telephone Number : 412-897-1827
Fax Number :
Provider Business Practice Location Address
First Line : 6315 FORBES AVE STE L110C
Second Line :
City : PITTSBURGH
State : PA
Zip : 15217-1745
Country : US
Telephone Number : 412-256-8753
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/03/2024

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Directions to “ MARY B KOCH RUIZ LPC” Practice Location

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