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Contact Information

MARY W RYAN, PHD
330 E LAKESIDE AVE STE B001
COEUR D'ALENE, ID83814-2834
 Phone: 208-243-8080
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARY W RYAN · (Female)

NPI Number 1932418183
Status Active
Credentials PHD
Entity Individual
Enumeration date 10/05/2010
Last updated 03/02/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # PY8457
  • WA License # PY60440889
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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