Individual
LISA M RYCKBOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
936 EASTWIND DR, WESTERVILLE, OH 43081-3329
(146) 634-6005
Mailing address
936 EASTWIND DR, WESTERVILLE, OH 43081-3329
(146) 634-6005
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-8849
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094740
—
OH
Enumeration date
07/24/2008
Last updated
05/29/2024
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