Individual
MR. KEVIN J RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
5127 TROON LN, DURHAM, NC 27712-1829
(919) 384-0323
Mailing address
5127 TROON LN, DURHAM, NC 27712-1829
(919) 384-0323
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
703
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19645
MAGELAN
NC
01
—
74105
BLUE CROSS BLUE SHIELD
NC
Enumeration date
02/15/2007
Last updated
07/08/2007
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