Provider Demographics
NPI:1598806945
Name:KOCIAN-FIGUEROA, MARY JANE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARY JANE
Middle Name:
Last Name:KOCIAN-FIGUEROA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MARY JANE
Other - Middle Name:
Other - Last Name:KOCIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:3095 KETTERING BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1921
Mailing Address - Country:US
Mailing Address - Phone:937-534-1312
Mailing Address - Fax:937-534-1347
Practice Address - Street 1:3095 KETTERING BLVD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45439-1921
Practice Address - Country:US
Practice Address - Phone:937-534-1312
Practice Address - Fax:937-534-1347
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5701103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical