| Doctor Name: | RYAN DAVID WELLS |
| NPI Number: | 1003152505 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | XL4067 |
| Business Practice Address: | 32 College Ave Suite 206 Waterville, ME - 049016100 |
| Business Phone Number: | 2076802065 |
| Business Fax Number: | 2076802068 |
| Mailing Address: | 157 Park St., Suite 5 BANGOR |
| State: | ME |
| Postal Code: | 04401 |
| Phone Number: | 2079920410 |
| Fax Number: | 2079920414 |
| NPI Enumeration Date: | 01/02/2013 |
| NPI Last Update Date: | 07/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | XL4067 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |