| Doctor Name: | MRS. JENNIFER LYNN RYAN |
| NPI Number: | 1083862197 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LADC |
| License Number: | 001059 |
| Business Practice Address: | 30 Controls Drive Suite 10 Shelton, CT - 064845434 |
| Business Phone Number: | 4756752981 |
| Business Fax Number: | 4756752982 |
| Mailing Address: | 30 Controls Drive, Suite 10 SHELTON |
| State: | CT |
| Postal Code: | 064845434 |
| Phone Number: | 4756752981 |
| Fax Number: | 4756752982 |
| NPI Enumeration Date: | 09/03/2008 |
| NPI Last Update Date: | 09/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 001059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |