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General NPI Number Information
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NPI Number | 1851010565
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Entity Type | Individual
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Provider Name | JONATHAN PATRICK RYAL ACMHC
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Gender | Male
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 347 N 300 W STE 201A
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City | KAYSVILLE
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State | UT
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Zip | 84037-1828
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Country | US
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Telephone | 385-231-8387
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Fax |
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Provider Business Mailing Address
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Address Line | 381 MOSS ROCK CIR
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City | WARRIOR
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State | AL
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Zip | 35180-5347
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Country | US
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Telephone | 352-882-6614
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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 | 12787429-6004
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC05359
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License Number State | AL
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