| Doctor Name: | DR. RYAN P FAULKNER |
| NPI Number: | 1174588560 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D |
| License Number: | 1397 |
| Business Practice Address: | 1000 S Fort Thomas Ave Rm 225 Fort Thomas, KY - 410752305 |
| Business Phone Number: | 5138613100 |
| Business Fax Number: | 8595726748 |
| Mailing Address: | 1000 S Fort Thomas Ave, Rm 225 FORT THOMAS |
| State: | KY |
| Postal Code: | 410752305 |
| Phone Number: | 5138613100 |
| Fax Number: | 8595726748 |
| NPI Enumeration Date: | 04/19/2006 |
| NPI Last Update Date: | 07/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1397 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |