Basic Information
| Provider Information | |||||||||
| NPI: | 1013415942 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RYKHUS | ||||||||
| FirstName: | TORRANCE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 715 HORIZON DR STE 225 | ||||||||
| Address2: | |||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815068743 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 439 BREEZE ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | CRAIG | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816252646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708246541 | ||||||||
| FaxNumber: | 9706837055 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2018 | ||||||||
| LastUpdateDate: | 06/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 101YM0800X | ACD.0001720 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.