Individual
DR. SHANNON VIRGINIA RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2416 SOUTH ST, PHILADELPHIA, PA 19146-1036
(267) 581-6067
Mailing address
10 WOODED LN, MEDIA, PA 19063-4936
(267) 581-6067
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS091812
PA
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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