Doctor Name: | MR. RUEBEN BROCK |
NPI Number: | 1144636101 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | PC007688 |
Business Practice Address: | 4150 Washington Rd Mc Murray, PA - 153172534 |
Business Phone Number: | 7242553544 |
Business Fax Number: | |
Mailing Address: | 303 Dearment Pkwy, PITTSBURGH |
State: | PA |
Postal Code: | 15241 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/10/2014 |
NPI Last Update Date: | 07/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC007688 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |