Individual
JAMIE A RYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
810 HARMONY ST, SUITE 302, COUNCIL BLUFFS, IA 51503
(712) 328-2609
(712) 328-2609
Mailing address
PO BOX 641130, OMAHA, NE 68164-7130
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001082
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200346670A
—
KS
Enumeration date
10/13/2006
Last updated
05/12/2011
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