Provider Demographics
NPI:1508579582
Name:BURKEY, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BURKEY
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 1:1200 CREAMERY LN
Mailing Address - Street 2:
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017-1499
Mailing Address - Country:US
Mailing Address - Phone:443-300-6362
Mailing Address - Fax:667-400-6110
Practice Address - Street 1:1200 CREAMERY LN
Practice Address - Street 2:
Practice Address - City:BELCAMP
Practice Address - State:MD
Practice Address - Zip Code:21017-1499
Practice Address - Country:US
Practice Address - Phone:443-300-6362
Practice Address - Fax:667-400-6110
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician