Provider Demographics
NPI:1689711103
Name:RUHANA, MARLA KAY (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARLA
Middle Name:KAY
Last Name:RUHANA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25490 LITTLE MACK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2157
Mailing Address - Country:US
Mailing Address - Phone:596-779-8003
Mailing Address - Fax:586-779-8146
Practice Address - Street 1:25490 LITTLE MACK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2157
Practice Address - Country:US
Practice Address - Phone:596-779-8003
Practice Address - Fax:586-779-8146
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010670351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical