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Individual

DR. RYAN BODDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9047 EXECUTIVE PARK DR STE 210, KNOXVILLE, TN 37923-4625
(865) 684-8034
Mailing address
9047 EXECUTIVE PARK DR STE 210, KNOXVILLE, TN 37923-4625
(865) 684-8034

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103G00000X
Clinical Neuropsychologist
Primary
3221
TN
103TC0700X
Clinical Psychologist
3221
TN

Other

Enumeration date
10/29/2013
Last updated
07/31/2020
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