Provider Demographics
NPI:1255611711
Name:PECSENYE, RYAN (MS, LLP)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:PECSENYE
Suffix:
Gender:M
Credentials:MS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7361 WINDSOR WOODS DR
Mailing Address - Street 2:1C
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2285
Mailing Address - Country:US
Mailing Address - Phone:810-923-5913
Mailing Address - Fax:
Practice Address - Street 1:7361 WINDSOR WOODS DR
Practice Address - Street 2:1C
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2285
Practice Address - Country:US
Practice Address - Phone:810-923-5913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014332103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical