Individual
STACY RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D., CCCA
Contact information
Practice address
10425 W NORTH AVE, WAUWATOSA, WAUWATOSA, WI 53226-2416
(414) 607-1830
Mailing address
636 N 75TH ST, WAUWATOSA, WAUWATOSA, WI 53213-3504
(414) 943-3802
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
486-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41153200
—
WI
Enumeration date
07/08/2006
Last updated
07/08/2007
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