Individual
RYAN EDWARD HUMPHRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1300 HAMPTON AVE STE 200, SAINT LOUIS, MO 63139-3163
(636) 439-0240
Mailing address
515 N MILL ST, FESTUS, MO 63028-1416
(636) 439-0240
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2025005204
MO
Other
Enumeration date
04/24/2025
Last updated
04/24/2025
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