Individual
KAYLA ANN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
410 S PINE ST, CENTRALIA, IL 62801-4028
(618) 816-2419
Mailing address
147 SYCAMORE ST, PIKEVILLE, KY 41501-9118
(618) 816-2419
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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