Provider Demographics
NPI:1093116584
Name:BRUCE, MARLEEN AVA (BS)
Entity Type:Individual
Prefix:MRS
First Name:MARLEEN
Middle Name:AVA
Last Name:BRUCE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 LONDON TOWNE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-1143
Mailing Address - Country:US
Mailing Address - Phone:412-207-7371
Mailing Address - Fax:
Practice Address - Street 1:3811 OHARA ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2561
Practice Address - Country:US
Practice Address - Phone:412-647-9380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health