| Life Span Psychological Services Pc | |
|
28190 Willow St Pk Willow Street PA 17584 | |
| (717) 464-1464 | |
| (717) 464-4348 |
| Full Name | Life Span Psychological Services Pc |
|---|---|
| Speciality | Social Worker |
| Location | 28190 Willow St Pk, Willow Street, Pennsylvania |
| Authorized Official Name and Position | Lynnette G Ruch (PHD) |
| Authorized Official Contact | 7174641464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Span Psychological Services Pc 28190 Willow St Pk Willow Street PA 17584 Ph: (717) 464-1464 | Life Span Psychological Services Pc 28190 Willow St Pk Willow Street PA 17584 Ph: (717) 464-1464 |
| NPI Number | 1912958356 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6305884057 |
|---|---|
| Medicare Enrollment ID | O20050422000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912958356 | NPI | - | NPPES |
| Provider Name | Lynnette G Ruch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629014741 PECOS PAC ID: 9032185996 Enrollment ID: I20040902000814 |
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