Individual
KELLY LAURA RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
265 S ANITA DR STE 201, ORANGE, CA 92868-3346
(714) 410-3505
(714) 410-3529
Mailing address
265 S ANITA DR STE 201, ORANGE, CA 92868-3346
(714) 410-3505
(714) 410-3529
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37853
CA
Other
Enumeration date
03/12/2015
Last updated
02/06/2024
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