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General NPI Number Information
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NPI Number | 1316717440
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Entity Type | Individual
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Provider Name | RYAN JAHNKE MA
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Gender | Male
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 44 OLD HIGHWAY 22
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City | CLINTON
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State | NJ
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Zip | 08809-1376
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Country | US
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Telephone | 908-237-9193
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Fax |
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Provider Business Mailing Address
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Address Line | 44 WILLOW RUN LN
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City | BELLE MEAD
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State | NJ
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Zip | 08502-4540
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Country | US
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Telephone | 908-566-6158
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC00808100
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License Number State | NJ
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