Individual
BRENDA RYAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
SPEECH LANGUAGE PATH
Contact information
Practice address
195 KANE ST, GATE CITY, VA 24251-3408
(276) 386-2454
(276) 386-1446
Mailing address
PO BOX 1807, GATE CITY, VA 24251-4807
(276) 386-2454
(276) 386-1446
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202002211
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
283587
BCBS
VA
05
—
4979681
—
VA
Enumeration date
10/14/2005
Last updated
07/08/2007
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