Provider Demographics
NPI:1245903418
Name:FLINN, RYAN ELLIOTT (PHD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ELLIOTT
Last Name:FLINN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 WALDEN DR APT A2
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6526
Mailing Address - Country:US
Mailing Address - Phone:402-575-7016
Mailing Address - Fax:
Practice Address - Street 1:997 SAINT SEBASTIAN WAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-2613
Practice Address - Country:US
Practice Address - Phone:706-721-7969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling