Provider Demographics
NPI:1548702400
Name:BRUCE, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BRUCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 RIDGELAKE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4973
Mailing Address - Country:US
Mailing Address - Phone:504-496-0212
Mailing Address - Fax:
Practice Address - Street 1:3032 RIDGELAKE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4973
Practice Address - Country:US
Practice Address - Phone:504-496-0212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator