DR. Ryan Lee Blackstock, PSY.D., LP
NPI #1104014273 in Brownstown Twp, Michigan
Provider Information
- NPI Number
- 1104014273
- Entity Type
- Individual
- Name
- DR. Ryan Lee Blackstock, PSY.D., LP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist
- Credential
- PSY.D., LP
- Enumeration Date
- Oct 13, 2007
- Last Updated
- Aug 27, 2010
Practice Location
- Address
- 19366 ALLEN RD
- Address 2
- SUITE C
- City
- Brownstown Twp
- State
- Michigan
- ZIP Code
- 48183-6809
- Phone
- (734) 479-0949
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist |
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