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Individual
GLEN W RYSWYK
Active
Individual
GLEN W RYSWYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDIV LPC LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
577
OK
106H00000X
Marriage & Family Therapist
717
OK
Other
Enumeration date
08/15/2006
Last updated
09/14/2011
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