Doctor Name: | MS. KELLY MCCABE RYAN |
NPI Number: | 1700091287 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., C.A.G.S.,, LMH |
License Number: | |
Business Practice Address: | 27 Burgate St Chepachet, RI - 028142303 |
Business Phone Number: | 4019528188 |
Business Fax Number: | |
Mailing Address: | 27 Burgate Street, CHEPACHET |
State: | RI |
Postal Code: | 028142303 |
Phone Number: | 4019528188 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 06/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |