Healthcare Provider Details

I. General information

NPI: 1548550288
Provider Name (Legal Business Name): RYAN RICHARD HEPLER MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

898 PARK AVE SUITE 12
MEADVILLE PA
16335-3335
US

IV. Provider business mailing address

9007 MAIN ST UNIT 4
MC KEAN PA
16426-1457
US

V. Phone/Fax

Practice location:
  • Phone: 814-807-1202
  • Fax: 866-303-0132
Mailing address:
  • Phone: 814-671-9384
  • Fax: 814-314-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: