Doctor Name: | JAMES M RYAN |
NPI Number: | 1558536102 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC LCADC CRC CDMS |
License Number: | LCA372 |
Business Practice Address: | 19586 Club House Rd Montgomery Village, MD - 208863002 |
Business Phone Number: | 3012587771 |
Business Fax Number: | 3012589078 |
Mailing Address: | 19586 Club House Rd, MONTGOMERY VILLAGE |
State: | MD |
Postal Code: | 208863002 |
Phone Number: | 3012587771 |
Fax Number: | 3012589078 |
NPI Enumeration Date: | 04/24/2008 |
NPI Last Update Date: | 04/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LCA372 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |