=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831369685
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAMMY L RUCH LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2008
-----------------------------------------------------
Last Update Date | 03/07/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | FAITH ACADEMY, PENNY LANE, VALLEY GOLF SUBD. DON CELSO TUAZON AVENUE
-----------------------------------------------------
City | CAINTA
-----------------------------------------------------
State | RIZAL
-----------------------------------------------------
Zip | 1900
-----------------------------------------------------
Country | PH
-----------------------------------------------------
Telephone | 632-658-0048
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | SIL P.O. BOX 2270 CPO
-----------------------------------------------------
City | MANILA
-----------------------------------------------------
State | PHILIPPINES
-----------------------------------------------------
Zip | 1099
-----------------------------------------------------
Country | PH
-----------------------------------------------------
Telephone | 7226186
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 4878
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------