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General NPI Number Information
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NPI Number | 1710289079
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Entity Type | Individual
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Provider Name | RUTH J. BICHSEL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 1345 BIRCH AVE
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City | COTTAGE GROVE
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State | OR
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Zip | 97424-1416
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Country | US
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Telephone | 541-767-4172
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1380
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City | COTTAGE GROVE
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State | OR
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Zip | 97424-0074
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Country | US
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Telephone | 541-653-7458
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1365
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License Number State | OR
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