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Individual

RYAN BURKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
610 W BROADWAY AVE, STE L1, JACKSON, WY 83001-8213
(307) 733-3908
(307) 734-0017
Mailing address
PO BOX 11390, JACKSON, WY 83002-1390
(307) 733-3908
(307) 734-0017

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LPC-1544
WY
101YA0400X
Addiction (Substance Use Disorder) Counselor
PPC 830
WY
101YP2500X
Professional Counselor
LPC-1544
WY

Other

Enumeration date
05/29/2014
Last updated
07/20/2022
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