Provider Demographics
NPI:1790040244
Name:REBECCA TRUAX MA INC
Entity Type:Organization
Organization Name:REBECCA TRUAX MA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUAX
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:484-574-1520
Mailing Address - Street 1:21 DOUGHERTY BLVD
Mailing Address - Street 2:UNIT T3
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1151
Mailing Address - Country:US
Mailing Address - Phone:484-574-1520
Mailing Address - Fax:610-932-2330
Practice Address - Street 1:307 N 3RD ST
Practice Address - Street 2:SUITE 3
Practice Address - City:OXFORD
Practice Address - State:PA
Practice Address - Zip Code:19363-1429
Practice Address - Country:US
Practice Address - Phone:484-574-1520
Practice Address - Fax:610-932-2330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006189L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty