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NPI Code Detail

MEDICARE: DR. RYAN CHRISTOPHER SHOREY PH.D.

MEDICARE: DR. RYAN CHRISTOPHER SHOREY PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist7337OH

General Provider Information

NPI Number : 1407384126
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN CHRISTOPHER SHOREY PH.D.
Provider Business Mailing Address
First Line : 239 PORTER HALL
Second Line :
City : ATHENS
State : OH
Zip : 45701-1368
Country : US
Telephone Number : 740-597-3298
Fax Number : 740-593-4790
Provider Business Practice Location Address
First Line : 1 OHIO UNIVERSITY DEPT OF PSYCHOLOGY, PORTER HALL ROOM
Second Line :
City : ATHENS
State : OH
Zip : 45701-2942
Country : US
Telephone Number : 740-593-0902
Fax Number : 740-593-4790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2017
Last Update Date : 07/21/2022

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