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NPI Code Detail

MEDICARE: MIMI RYAN LPC

MEDICARE: MIMI RYAN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4567LA

General Provider Information

NPI Number : 1306616347
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIMI RYAN LPC
Provider Business Mailing Address
First Line : 2002 GENERAL PERSHING ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70115-5436
Country : US
Telephone Number : 504-527-8783
Fax Number :
Provider Business Practice Location Address
First Line : 1426 AMELIA ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70115-3622
Country : US
Telephone Number : 504-527-8783
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2024
Last Update Date : 01/02/2024

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Directions to “ MIMI RYAN LPC” Practice Location

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