Provider Demographics
NPI:1447453790
Name:BUSH, RACHEL WILHELM (PHD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:WILHELM
Last Name:BUSH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 HORSESHOE HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:POUND RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10576
Mailing Address - Country:US
Mailing Address - Phone:914-764-0322
Mailing Address - Fax:914-764-1440
Practice Address - Street 1:40 HORSESHOE HILL ROAD
Practice Address - Street 2:
Practice Address - City:POUND RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10576
Practice Address - Country:US
Practice Address - Phone:914-764-0322
Practice Address - Fax:914-764-1440
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0104541103TC0700X
CT001611103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical