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NPI Code Detail

MEDICARE: RYAN TRAVERS

MEDICARE: RYAN TRAVERS
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
1103K00000XBehavior Analyst1-24-73599TN

General Provider Information

NPI Number : 1518704188
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN TRAVERS
Provider Business Mailing Address
First Line : 1605 54TH AVE N APT 305
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-1588
Country : US
Telephone Number : 845-248-2597
Fax Number :
Provider Business Practice Location Address
First Line : 652 W IRIS DR
Second Line :
City : NASHVILLE
State : TN
Zip : 37204-3154
Country : US
Telephone Number : 615-426-8393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2024
Last Update Date : 07/11/2024

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Directions to “ RYAN TRAVERS ” Practice Location

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