Provider Demographics
NPI:1851680433
Name:MCMAHAN, RYAN PATRICK (PSRS)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:PATRICK
Last Name:MCMAHAN
Suffix:
Gender:M
Credentials:PSRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:RESOURCE MANAGEMENT
Mailing Address - Street 2:1300 HOPPE BLVD., SUITE 1
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:1300 HOPPE BLVD.
Practice Address - Street 2:SUITE 5
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820
Practice Address - Country:US
Practice Address - Phone:580-436-1222
Practice Address - Fax:580-436-1333
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OK6393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health