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NPI Code Detail

MEDICARE: MRS. DARIA LEE RYAN

MEDICARE:  MRS. DARIA LEE 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
1235Z00000XSpeech-Language PathologistSP-1742NV

General Provider Information

NPI Number : 1912190273
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DARIA LEE RYAN
Provider Business Mailing Address
First Line : 2204 CLUB PACIFIC WAY # 11-102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-1076
Country : US
Telephone Number : 631-903-7018
Fax Number :
Provider Business Practice Location Address
First Line : 366 E MESA VERDE LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-1812
Country : US
Telephone Number : 702-227-4477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2007
Last Update Date : 10/03/2014

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Directions to “ MRS. DARIA LEE RYAN ” Practice Location

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