Individual
MS. PATRICIA EILEEN RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
120 TAYLOR RD, WHITEFISH, MT 59937-8419
(406) 212-7016
Mailing address
PO BOX 815, WHITEFISH, MT 59937-0815
(406) 862-2208
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-344
MT
225700000X
Massage Therapist
LMT 627
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000070851
BLUE CROSS/ BLUE SHIELD
MT
05
—
0000502749
—
MT
Enumeration date
09/29/2006
Last updated
11/28/2012
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