Organization
LIFE SPAN PSYCHOLOGICAL SERVICES PC
Active
Organization
LIFE SPAN PSYCHOLOGICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNNETTE G RUCH PHD (PHD)
(717) 464-1464
Entity
Organization
Contact information
Practice address
28190 WILLOW ST PK, WILLOW STREET, PA 17584
(717) 464-1464
(717) 464-4348
Mailing address
28190 WILLOW ST PK, WILLOW STREET, PA 17584
(717) 464-1464
(717) 464-4348
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC002382
PA
103TC0700X
Clinical Psychologist
Primary
PS006874L
PA
104100000X
Social Worker
SW011339L
PA
1041C0700X
Clinical Social Worker
SW123210L
PA
Other
Enumeration date
05/12/2006
Last updated
09/11/2025
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