Individual
RYAN WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
2509 S POWER RD STE 110, MESA, AZ 85209-6696
(480) 912-4691
Mailing address
4025 E GAIL CT, GILBERT, AZ 85296-9603
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-23093
AZ
Other
Enumeration date
11/25/2025
Last updated
11/25/2025
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