Provider Demographics
NPI:1700055563
Name:MARLIN, RUTH VIVIAN (MA, MMH, DD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:VIVIAN
Last Name:MARLIN
Suffix:
Gender:F
Credentials:MA, MMH, DD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3169 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-2823
Mailing Address - Country:US
Mailing Address - Phone:215-426-9680
Mailing Address - Fax:215-426-9683
Practice Address - Street 1:3169 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-2823
Practice Address - Country:US
Practice Address - Phone:215-426-9680
Practice Address - Fax:215-426-9683
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health