Individual
RYAN EDGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 W DRAGOON TRL, MISHAWAKA, IN 46544-4713
(574) 855-4292
(574) 635-3201
Mailing address
1316 W DRAGOON TRL, MISHAWAKA, IN 46544-4713
(574) 855-4292
(574) 635-3201
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12259957
IN
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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