Provider Demographics
NPI:1407748817
Name:RUCH, CHERI JOAN
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:JOAN
Last Name:RUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:JOAN
Other - Last Name:RUCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4400 W CAMAS ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-5827
Mailing Address - Country:US
Mailing Address - Phone:208-866-0565
Mailing Address - Fax:
Practice Address - Street 1:1217 3RD ST S STE 103
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-1003
Practice Address - Country:US
Practice Address - Phone:208-803-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health