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Organization

JAMES M RYAN

Active
Other names
Ryan Rehabilitation
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TRACY ASBURY (BILLING MANAGER)
(301) 942-9773
Entity
Organization

Contact information

Practice address
19586 CLUB HOUSE RD, MONTGOMERY VILLAGE, MD 20886-3002
(301) 258-7771
(301) 258-9078
Mailing address
19586 CLUB HOUSE RD, MONTGOMERY VILLAGE, MD 20886-3002
(301) 258-7771
(301) 258-9078

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA372
MD
101YM0800X
Mental Health Counselor
Primary
LC1361
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
415645500
MD
Enumeration date
03/18/2014
Last updated
03/18/2014
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