Ryan, Mary T.

Ryan, Mary T. is an sole proprietor health care provider with primary practice located at 535 Cache Creek Dr , Jackson WY 83001-8653. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Dietary & Nutritional Service Providers / Dietitian, Registered. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Ryan, Mary T. can be contacted via phone (307) 690-5785.

Contact Information

Primary practice address
535 Cache Creek Dr Jackson WY 83001-8653
Phone: (307) 690-5785
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 800 Wyoming
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 886773 Wyoming

Profile Details

NPI number 1427268952
LBN Legal business name Ryan, Mary T.
Credentials M.S., R.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2007
Last updated Mar 6th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427268952 NPPES
Wyoming MEDICAID 116673500

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