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Individual

MR. TIMOTHY RYAN RYSAVY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD, LP

Contact information

Practice address
251 COUNTY ROAD 120, ST. CLOUD, MN 56303-4872
(320) 258-3833
(320) 253-5741
Mailing address
P.O. BOX 230, SARTELL, MN 56377-0230
(320) 258-3833
(320) 253-5741

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6105
MN

Other

Enumeration date
02/22/2017
Last updated
02/22/2017
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