Individual
MRS. TIFFANY RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD
Contact information
Practice address
6 FARRAH CV, PARAGOULD, AR 72450-7466
(870) 897-2372
Mailing address
6 FARRAH CV, PARAGOULD, AR 72450-7466
(870) 897-2372
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2248
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154750721
—
AR
01
—
5Y086
BLUE CROSS & BLUE SHIELD
AR
Enumeration date
12/04/2006
Last updated
08/10/2010
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