Individual
RYAN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4710 EAGLERIDGE CIR STE 230, PUEBLO, CO 81008-2176
(719) 582-8736
(719) 434-9767
Mailing address
4710 EAGLERIDGE CIR, PUEBLO, CO 81008-2176
(719) 582-8736
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-82484
CO
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/29/2022
Last updated
07/11/2025
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