Provider Demographics
NPI:1528204559
Name:BUHITE, RYAN LUTHER (PSY D)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:LUTHER
Last Name:BUHITE
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N. FIRST STREET
Mailing Address - Street 2:97 MDOS/SGOW BLDG 46
Mailing Address - City:ALTUS AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73523-5005
Mailing Address - Country:US
Mailing Address - Phone:580-481-5376
Mailing Address - Fax:580-481-5374
Practice Address - Street 1:301 N FIRST STREET
Practice Address - Street 2:97 MDOS/SGOW BLDG 46
Practice Address - City:ALTUS AFB
Practice Address - State:OK
Practice Address - Zip Code:73523-5005
Practice Address - Country:US
Practice Address - Phone:580-481-5376
Practice Address - Fax:580-481-5374
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 016-556103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical