Individual
BRYAN VAN RAVENHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1141 W SHAW AVE STE 203, FRESNO, CA 93711-3713
(559) 428-3137
Mailing address
PO BOX 26813, FRESNO, CA 93729-6813
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
105285
CA
Other
Enumeration date
09/08/2021
Last updated
08/24/2023
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