Provider Demographics
NPI:1679301345
Name:RYANS, DONALD (LADAC I)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:RYANS
Suffix:
Gender:M
Credentials:LADAC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W STRANG ST
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37854-2022
Mailing Address - Country:US
Mailing Address - Phone:865-207-5790
Mailing Address - Fax:
Practice Address - Street 1:511 W STRANG ST
Practice Address - Street 2:
Practice Address - City:ROCKWOOD
Practice Address - State:TN
Practice Address - Zip Code:37854-2022
Practice Address - Country:US
Practice Address - Phone:865-207-5790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1676101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)