MEDICARE: MRS. RUTH J. COHEN M.A., L.M.F.T.

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
1	106H00000X	Marriage & Family Therapist	MFT-32424	CA
2	163WL0100X	Lactation Consultant (Registered Nurse)	358988	CA
3	106H00000X	Marriage & Family Therapist	10219	AZ

General Provider Information

NPI Number	:	1528028529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RUTH J. COHEN M.A., L.M.F.T.

Provider Business Mailing Address
First Line	:	19920 N CANYON WHISPER DR
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85387-7269
Country	:	US
Telephone Number	:	623-337-3388
Fax Number	:	623-322-1938

Provider Business Practice Location Address
First Line	:	16804 W PALISADE TRAIL LN # 12
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85387-7229
Country	:	US
Telephone Number	:	623-337-3388
Fax Number	:	623-298-2068

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	10/23/2020

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