Individual
KIMBERLY O RYAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA LP
Contact information
Practice address
2345 ARIEL STREET NORTH, MAIL STOP 13601A, MAPLEWOOD, MN 55109-2248
(651) 254-4793
(651) 254-0877
Mailing address
8100 34TH AVE S, 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-7961
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0310
MN
Other
Enumeration date
03/23/2006
Last updated
07/08/2007
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