Provider Demographics
NPI:1780439471
Name:DRAPER, RYEN
Entity type:Individual
Prefix:
First Name:RYEN
Middle Name:
Last Name:DRAPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 AMBROSE HILL LN
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:NC
Mailing Address - Zip Code:27591-3327
Mailing Address - Country:US
Mailing Address - Phone:734-787-4895
Mailing Address - Fax:
Practice Address - Street 1:4904 WATERS EDGE DR STE 153
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2397
Practice Address - Country:US
Practice Address - Phone:919-285-4802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10185A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist