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General NPI Number Information
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NPI Number | 1407384126
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Entity Type | Individual
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Provider Name | RYAN CHRISTOPHER SHOREY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1 OHIO UNIVERSITY DEPT OF PSYCHOLOGY, PORTER HALL ROOM
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City | ATHENS
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State | OH
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Zip | 45701-2942
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Country | US
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Telephone | 740-593-0902
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Fax | 740-593-4790
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Provider Business Mailing Address
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Address Line | 239 PORTER HALL
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City | ATHENS
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State | OH
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Zip | 45701-1368
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Country | US
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Telephone | 740-597-3298
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Fax | 740-593-4790
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 7337
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License Number State | OH
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