Individual
RYAN LAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11350 E PALMER WASILLA HWY, PALMER, AK 99645-7425
(530) 680-3010
Mailing address
780 N LUKE ST, WASILLA, AK 99654-6651
(530) 680-3010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
208457
AK
Other
Enumeration date
03/17/2015
Last updated
11/15/2023
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