MEDICARE: MRS. JENNIFER N RYAN BCBA, LBA

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
1	103K00000X	Behavior Analyst	1-26-90079	TX
2	103K00000X	Behavior Analyst	BHV-010361	TX

General Provider Information

NPI Number	:	1730010513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER N RYAN BCBA, LBA

Provider Business Mailing Address
First Line	:	115 FM 2453 STE A
Second Line	:
City	:	ROYSE CITY
State	:	TX
Zip	:	75189-7037
Country	:	US
Telephone Number	:	254-833-0537
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 FM 2453 STE A
Second Line	:
City	:	ROYSE CITY
State	:	TX
Zip	:	75189-7037
Country	:	US
Telephone Number	:	254-833-0537
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/29/2026

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