Individual
DR. KYLE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
411 E PARK ST STE 106, CHAMPAIGN, IL 61820-3862
(631) 332-7736
Mailing address
411 E PARK ST STE 106, CHAMPAIGN, IL 61820-3862
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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