Provider Demographics
NPI:1407293400
Name:EPLEY, RYAN CHASE
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:CHASE
Last Name:EPLEY
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 1:11212 LARKIN LN
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-3826
Mailing Address - Country:US
Mailing Address - Phone:405-550-5046
Mailing Address - Fax:
Practice Address - Street 1:11212 LARKIN LN
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-3826
Practice Address - Country:US
Practice Address - Phone:405-550-5046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor