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General NPI Number Information
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NPI Number | 1477629343
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Entity Type | Individual
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Provider Name | KRISTIN ANN RYAN M.S.
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Gender | Female
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2429 CLOCK FACE CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-1333
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Country | US
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Telephone | 770-331-9988
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Fax |
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Provider Business Mailing Address
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Address Line | 2429 CLOCK FACE CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-1333
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Country | US
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Telephone | 770-331-9988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC003658
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License Number State | GA
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