Provider Demographics
NPI:1104158872
Name:RYKEN, DEBORAH ANN (MS, PLPC)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:RYKEN
Suffix:
Gender:F
Credentials:MS, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:BATES CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64011-9124
Mailing Address - Country:US
Mailing Address - Phone:816-522-8866
Mailing Address - Fax:816-690-8293
Practice Address - Street 1:410B SE 3RD ST STE 101
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2842
Practice Address - Country:US
Practice Address - Phone:816-522-8866
Practice Address - Fax:816-690-8293
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010002433101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional