Individual
ROSEMARY BRUCKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
9617 CASTLEROY LN, ROWLETT, TX 75089-8366
(937) 657-0019
Mailing address
PO BOX 2147, ROWLETT, TX 75030-2147
(937) 657-0019
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5657
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000391396
ANTHEM BC BS
OH
05
—
2365748
—
OH
01
—
680015634
RAILROAD MEDICARE
OH
Enumeration date
05/15/2006
Last updated
02/18/2014
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