Individual
MR. RYAN TIMOTHY FLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1454 MEXICO WAY NE, ROANOKE, VA 24012-6476
(434) 533-1088
Mailing address
6430 ARCHCREST DR APT 106, ROANOKE, VA 24019-1185
(540) 580-6221
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701013243
VA
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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