Provider Demographics
NPI:1932760683
Name:RUH, ALEXANDRIA LYNN (LIMHP, LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:LYNN
Last Name:RUH
Suffix:
Gender:F
Credentials:LIMHP, LCMHC
Other - Prefix:MISS
Other - First Name:ALEXANDRIA
Other - Middle Name:LYNN
Other - Last Name:KOSISKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5808 M ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68117-1744
Mailing Address - Country:US
Mailing Address - Phone:402-320-9987
Mailing Address - Fax:
Practice Address - Street 1:11404 W DODGE RD UNIT 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2511
Practice Address - Country:US
Practice Address - Phone:402-898-1113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10543101YM0800X
NC11924101YM0800X
NE2587101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health