Healthcare Provider Details

I. General information

NPI: 1295133403
Provider Name (Legal Business Name): NANCY RUHE MS,NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2014
Last Update Date: 12/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N WATER ST
PAULDING OH
45879-1251
US

IV. Provider business mailing address

405 N WATER ST
PAULDING OH
45879-1251
US

V. Phone/Fax

Practice location:
  • Phone: 419-399-4656
  • Fax: 419-399-2404
Mailing address:
  • Phone: 419-399-4656
  • Fax: 419-399-2404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOS1044172
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: