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Individual

MARILOU G RUBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS AUD

Contact information

Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(419) 905-7037
Mailing address
19 BARRINGTON RD, HORSEHEADS, NY 14845-2272
(419) 905-7037

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
23001082A
IN
231H00000X
Audiologist
A0000001464
TN
231H00000X
Audiologist
Primary
AT006243
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10032658
SIGNATURE HEALTH ALLIANCE
TN
01
1138236
WINDSOR MEDICARE ADVANTAGE
TN
05
3192016
TN
01
4166173
BLUE CROSS/BLUE SHIELD
TN
01
9277081
AETNA
01
9368045
CIGNA
Enumeration date
07/06/2006
Last updated
06/05/2012
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