Individual
GINGER D RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
11092 BASTIAN RD, WATERMAN, IL 60556-7005
(630) 659-4259
Mailing address
PO BOX 151, WATERMAN, IL 60556-0151
(630) 659-4259
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-53228
IL
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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