Individual
RYAN GORDON BEALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, TLLP
Contact information
Practice address
1200 N TELEGRAPH RD, BUILDING 32 EAST, PONTIAC, MI 48341-1032
(248) 451-2600
Mailing address
13343 NADINE AVE, HUNTINGTON WOODS, MI 48070-1422
(312) 543-1333
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301016481
MI
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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