Individual
MARY WHITNEY RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
330 E LAKESIDE AVE STE B001, COEUR D ALENE, ID 83814-2834
(208) 243-8080
Mailing address
711 N 8TH ST, COEUR D ALENE, ID 83814-4255
(305) 710-2877
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60440889
WA
103TC0700X
Clinical Psychologist
PY60440889
WA
103TC0700X
Clinical Psychologist
PY8457
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY60440889
WA
Other
Enumeration date
10/05/2010
Last updated
03/02/2024
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