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NPI Code Detail

MEDICARE: LINDSAY RYAN

MEDICARE: LINDSAY RYAN
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 Analyst2018034576MO

General Provider Information

NPI Number : 1558845826
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY RYAN
Provider Business Mailing Address
First Line : 2644 METRO BLVD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2412
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2644 METRO BLVD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2412
Country : US
Telephone Number : 314-395-9375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2018
Last Update Date : 09/21/2018

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Directions to “ LINDSAY RYAN ” Practice Location

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