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Individual

MRS. ELISABETH ELLIS RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS CCC/SLP

Contact information

Practice address
2832 SW RIVIERA RD, STUART, FL 34997-1218
(772) 221-8999
Mailing address
2832 SW RIVIERA RD, STUART, FL 34997-1218
(772) 221-8999

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA6353
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
887114100
FL
Enumeration date
01/28/2010
Last updated
01/28/2010
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