Provider Demographics
NPI:1619743754
Name:RYAN MARRIAGE AND FAMILY RELATIONSHIP THERAPIST, LLC
Entity Type:Organization
Organization Name:RYAN MARRIAGE AND FAMILY RELATIONSHIP THERAPIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT LISAC
Authorized Official - Phone:623-399-2267
Mailing Address - Street 1:18205 N 51ST AVE STE 136
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1492
Mailing Address - Country:US
Mailing Address - Phone:623-399-2267
Mailing Address - Fax:866-340-1836
Practice Address - Street 1:18205 N 51ST AVE STE 136
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1492
Practice Address - Country:US
Practice Address - Phone:623-399-2267
Practice Address - Fax:866-340-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health