Provider Demographics
NPI:1538688759
Name:CRITSER, RYAN (MS LPC-CANDIDATE)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:CRITSER
Suffix:
Gender:M
Credentials:MS LPC-CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1710
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:OK
Mailing Address - Zip Code:73439-1710
Mailing Address - Country:US
Mailing Address - Phone:580-564-7374
Mailing Address - Fax:580-564-7362
Practice Address - Street 1:115 W BROADWAY ST STE 401
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6210
Practice Address - Country:US
Practice Address - Phone:140-576-2105
Practice Address - Fax:405-762-1055
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor