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Individual

MR. MARK ALLEN RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
3242 QUINCY ST, BUTTE, MT 59701-4444
(406) 498-5836
Mailing address
3242 QUINCY ST, BUTTE, MT 59701-4444
(406) 498-5836

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1365
MT
101YP2500X
Professional Counselor
002638
MO
106H00000X
Marriage & Family Therapist
300130
MO

Other

Enumeration date
10/12/2009
Last updated
10/12/2009
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