Individual
JASON B RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
935 STATE ROUTE VV, KENNETT, MO 63857
(573) 888-5925
Mailing address
935 STATE ROUTE VV, KENNETT, MO 63857-3822
(573) 888-5925
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010003885
MO
Other
Enumeration date
11/19/2010
Last updated
04/01/2019
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