NPI 1003544784

Ryan McMicking

Practitioner Behavior Technician Northbrook, IL

Practice location

Address: 85 Revere Dr STE Aa, Northbrook, IL 60062-8001
Phone: (844) 247-7222
Fax: (215) 489-8766
Mailing address: PO Box 639561, Cincinnati, OH 45263-9561

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence RBT-22-226946 (IL)

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Registry record

NPI: 1003544784
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Aug 2022
Record last updated: 10 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.