Provider Demographics
NPI:1992098636
Name:NIEHUS, RYAN PAUL (PSYD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:PAUL
Last Name:NIEHUS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173180
Mailing Address - Street 2:MSU COUNSELING AND PSYCHOLOGICAL SERVICES
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59717-3180
Mailing Address - Country:US
Mailing Address - Phone:406-994-4531
Mailing Address - Fax:406-994-2485
Practice Address - Street 1:211 SWINGLE HALL
Practice Address - Street 2:MSU COUNSELING AND PSYCHOLOGICAL SERVICES
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59717
Practice Address - Country:US
Practice Address - Phone:406-994-4531
Practice Address - Fax:406-994-2485
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT402103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical