Doctor Name: | MR. IVAN RYOTA IRIE |
NPI Number: | 1134334683 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | |
Business Practice Address: | 1431 N Western Ave Suite 406 Chicago, IL - 606221797 |
Business Phone Number: | 3124915085 |
Business Fax Number: | |
Mailing Address: | 41-1347 Kalanianaole Hwy, WAIMANALO |
State: | HI |
Postal Code: | 967951247 |
Phone Number: | 8082597948 |
Fax Number: | 8082597447 |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 12/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |