Provider Demographics
NPI:1902135528
Name:SCHWECK, RYAN A (BCABA)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:A
Last Name:SCHWECK
Suffix:
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 INTERSTATE NORTH CIR SE STE 430
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2244
Mailing Address - Country:US
Mailing Address - Phone:770-956-8511
Mailing Address - Fax:
Practice Address - Street 1:280 INTERSTATE NORTH CIR SE STE 430
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2244
Practice Address - Country:US
Practice Address - Phone:770-956-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0-09-3053103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst