Individual
ILONA CASEY RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2584 RW JOHNSON BOULEVVARD SW, TUMWATER, WA 98512
(360) 878-6434
Mailing address
3231 WILLAMETTE DR NE STE A, LACEY, WA 98516-1378
(253) 455-4625
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61608420
WA
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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