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Individual

KELLY A RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LMFT

Contact information

Practice address
903 WESSEX WAY, AUSTIN, TX 78748-6436
(512) 769-9845
Mailing address
903 WESSEX WAY, AUSTIN, TX 78748-6436
(512) 769-9845

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
79354
TX
106H00000X
Marriage & Family Therapist
203247
TX

Other

Enumeration date
08/10/2021
Last updated
08/10/2021
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