MEDICARE: DR. RONALD DEAN CROUCH PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1339	HI
2	103TC0700X	Clinical Psychologist	2690	OR

General Provider Information

NPI Number	:	1619223328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD DEAN CROUCH PH.D.

Provider Business Mailing Address
First Line	:	LANDSTUHL REGIONAL MEDICAL CENTER
Second Line	:	UNIT 33100
City	:	APO
State	:	WA
Zip	:	09180-3100
Country	:	US
Telephone Number	:	314-590-5326
Fax Number	:

Provider Business Practice Location Address
First Line	:	LANDSTUHL REGIONAL MEDICAL CENTER
Second Line	:	BUILDING 3810 OFFICE 342
City	:	APO
State	:	WA
Zip	:	09810-3100
Country	:	US
Telephone Number	:	314-590-5326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	09/28/2022

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