Doctor Name: | CARRISA J RYAN |
NPI Number: | 1073667119 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. , LPC |
License Number: | 5575 |
Business Practice Address: | 10210 Hickorywood Hill Ave Suite 210 Huntersville, NC - 280783332 |
Business Phone Number: | 7046512180 |
Business Fax Number: | |
Mailing Address: | 10210 Hickorywood Hill Ave, Suite 210 HUNTERSVILLE |
State: | NC |
Postal Code: | 280783332 |
Phone Number: | 7046512180 |
Fax Number: | |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 05/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 5575 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |