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NPI Code Detail

MEDICARE: KRISTIN RYAN

MEDICARE: KRISTIN 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 Analyst

General Provider Information

NPI Number : 1720962665
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN RYAN
Provider Business Mailing Address
First Line : 5110 GREYFIELD PL S
Second Line :
City : VALDOSTA
State : GA
Zip : 31605-7086
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3121 N OAK STREET EXT
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1099
Country : US
Telephone Number : 800-832-9419
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2025
Last Update Date : 04/13/2026

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Directions to “ KRISTIN RYAN ” Practice Location

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