Provider Demographics
NPI:1235481946
Name:RYBARCZYK, SUE ANN MARIE (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:SUE ANN
Middle Name:MARIE
Last Name:RYBARCZYK
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 S LLOYD DR
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-9111
Mailing Address - Country:US
Mailing Address - Phone:417-753-5211
Mailing Address - Fax:
Practice Address - Street 1:776 S LLOYD DR
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-9111
Practice Address - Country:US
Practice Address - Phone:417-753-5211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012033768101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor