Doctor Name: | MR. RYAN S OGILVY |
NPI Number: | 1063778819 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.W., L.C.S.W |
License Number: | 34006440A |
Business Practice Address: | 129 W Tidewater Trl Columbia City, IN - 467257775 |
Business Phone Number: | 2602299565 |
Business Fax Number: | |
Mailing Address: | 129 W Tidewater Trl, COLUMBIA CITY |
State: | IN |
Postal Code: | 467257775 |
Phone Number: | 2602299565 |
Fax Number: | |
NPI Enumeration Date: | 04/05/2012 |
NPI Last Update Date: | 04/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 34006440A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |