Healthcare Provider Details

I. General information

NPI: 1609128776
Provider Name (Legal Business Name): RYAN PRICE PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 10/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 SPRING VALLEY DR MENTAL HEALTH (116B)
HUNTINGTON WV
25704-9300
US

IV. Provider business mailing address

1540 SPRING VALLEY DR MENTAL HEALTH (116B)
HUNTINGTON WV
25704-9300
US

V. Phone/Fax

Practice location:
  • Phone: 304-429-6741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1700
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: