Individual
DR. RYAN J HULBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2273 E GALA ST, SUITE 100, MERIDIAN, ID 83642-7289
(208) 898-8999
Mailing address
24108 TEN DAVIS RD, PARMA, ID 83660-7212
(208) 722-5033
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-282
ID
103TC0700X
Clinical Psychologist
PSY-282
ID
103TC1900X
Counseling Psychologist
PSY-282
ID
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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