Doctor Name: | STEVEN RYDIN |
NPI Number: | 1124282850 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 12005 E 470 Road Claremore, OK - 74017 |
Business Phone Number: | 9183420770 |
Business Fax Number: | 9183420087 |
Mailing Address: | 1354 E 58th Street, TULSA |
State: | OK |
Postal Code: | 74105 |
Phone Number: | 9182695866 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2008 |
NPI Last Update Date: | 07/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |