Provider Demographics
NPI:1215566708
Name:WRIGHT, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 G ST SW APT B505
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-4351
Mailing Address - Country:US
Mailing Address - Phone:202-848-8232
Mailing Address - Fax:
Practice Address - Street 1:INTEGRATED BEHAVIORAL SOLUTIONS GROUP INC.
Practice Address - Street 2:3200 S ST. S.E.
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020
Practice Address - Country:US
Practice Address - Phone:202-610-1444
Practice Address - Fax:202-610-1445
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00623101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health