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Ryan Bridendolph
Peer Specialist in Vinita, Oklahoma
NPI 1427420157

Ryan Bridendolph is a Peer Specialist based in Vinita, OK. Ryan Bridendolph practices in Vinita, OK. The NPI Number for Ryan Bridendolph is 1427420157 and holds a License No. (Oklahoma).

The current practice location address for Ryan Bridendolph is 405 E Excelsior Ave, Vinita, OK and can be reached out via phone at 918-256-6476 and via fax at 918-256-3628.

Location: 405 E Excelsior Ave, Vinita, OK, 74301-4226
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1427420157
Provider Name
Ryan Bridendolph
Credential
Provider Entity Type
Individual
Gender
Male
Address
405 E Excelsior Ave, Vinita, OK, 74301-4226
Phone Number
918-256-6476
Fax Number
918-256-3628
Provider Enumeration Date
10/21/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
405 E Excelsior Ave
City
Vinita
State
Oklahoma
Zip
74301-4226
Phone Number
918-256-6476
Fax Number
918-256-3628
person
Provider Business Mailing Address Details
Address
405 E Excelsior Ave
City
Vinita
State
Oklahoma
Zip
74301-4226
Phone Number
918-256-6476
Fax Number
918-256-3628
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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