Individual
SAMANTHA NICOLE RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
500 NORTHSIDE XING STE A, MACON, GA 31210-2377
(855) 832-6727
Mailing address
421 COURTNEY LN, PERRY, GA 31069-9378
(972) 273-9908
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-71521
GA
Other
Enumeration date
07/11/2019
Last updated
02/27/2024
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