Healthcare Provider Details

I. General information

NPI: 1245142330
Provider Name (Legal Business Name): FELICIA MARIE RYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6850 HILLTOP RD
SHAWNEE KS
66226-3576
US

IV. Provider business mailing address

13901 W 63RD TER APT 81
SHAWNEE KS
66216-2243
US

V. Phone/Fax

Practice location:
  • Phone: 913-431-2511
  • Fax:
Mailing address:
  • Phone: 509-824-5824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: