Individual
MRS. SHIRLEY ANN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMHC, LMFTA
Contact information
Practice address
2525 LAKE AVE, FORT WAYNE, IN 46805-5407
(260) 484-4153
Mailing address
6722 CANBY DR, FORT WAYNE, IN 46835-1615
(260) 402-0334
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39002614A
IN
106H00000X
Marriage & Family Therapist
Primary
85000067A
IN
Other
Enumeration date
04/10/2011
Last updated
03/28/2015
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