Provider Demographics
NPI:1609222892
Name:RUCH, EMILY (PSYD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:RUCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5006 E TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3647
Mailing Address - Country:US
Mailing Address - Phone:717-961-6983
Mailing Address - Fax:
Practice Address - Street 1:108 KEEFER WAY
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-9228
Practice Address - Country:US
Practice Address - Phone:717-961-6983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019291103TC0700X
PABH002881103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst