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General NPI Number Information
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NPI Number | 1679102511
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Entity Type | Individual
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Provider Name | ARTHUR THOMAS RYAN PHD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 1700 WHEELING ST # G-3116M
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City | AURORA
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State | CO
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Zip | 80045-7211
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Country | US
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Telephone | 720-723-6493
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 LINDEN PL NE
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City | WASHINGTON
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State | DC
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Zip | 20002-4455
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Country | US
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Telephone | 404-604-7095
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1001413
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 05891
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License Number State | MD
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