Healthcare Provider Details
I. General information
NPI: 1831369685
Provider Name (Legal Business Name): TAMMY L RUCH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/07/2008
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
FAITH ACADEMY, PENNY LANE, VALLEY GOLF SUBD. DON CELSO TUAZON AVENUE
CAINTA RIZAL
1900
PH
IV. Provider business mailing address
SIL P.O. BOX 2270 CPO
MANILA PHILIPPINES
1099
PH
V. Phone/Fax
- Phone: 632-658-0048
- Fax:
- Phone: 7226186
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 4878 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: