Provider Demographics
NPI:1407384126
Name:SHOREY, RYAN CHRISTOPHER (PHD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:CHRISTOPHER
Last Name:SHOREY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 PORTER HALL
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1368
Mailing Address - Country:US
Mailing Address - Phone:740-597-3298
Mailing Address - Fax:740-593-4790
Practice Address - Street 1:1 OHIO UNIVERSITY DEPT OF PSYCHOLOGY, PORTER HALL ROOM
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2942
Practice Address - Country:US
Practice Address - Phone:740-593-0902
Practice Address - Fax:740-593-4790
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7337103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical