Provider Demographics
NPI:1043562903
Name:RYAN, SARAH MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIE
Last Name:RYAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 5TH AVE E
Mailing Address - Street 2:CDRC RM 262
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-7424
Mailing Address - Country:US
Mailing Address - Phone:205-348-9133
Mailing Address - Fax:205-348-3157
Practice Address - Street 1:651 5TH AVE E
Practice Address - Street 2:CDRC RM 262
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-7424
Practice Address - Country:US
Practice Address - Phone:205-348-9133
Practice Address - Fax:205-348-3157
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1781103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist