Provider Demographics
NPI:1902079056
Name:RAUCK, RACHEAL EILEEN (PSYD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:RACHEAL
Middle Name:EILEEN
Last Name:RAUCK
Suffix:
Gender:F
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 AMANDA LN
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40011-6222
Mailing Address - Country:US
Mailing Address - Phone:502-732-5465
Mailing Address - Fax:
Practice Address - Street 1:3200 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2213
Practice Address - Country:US
Practice Address - Phone:513-861-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042212A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical