Individual
CAROLYN TERESA RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LCAT, ATR-BC
Contact information
Practice address
3 MALCOLM ST, WEST BABYLON, NY 11704-8023
(631) 988-0667
Mailing address
3 MALCOLM ST, WEST BABYLON, NY 11704-8023
(631) 988-0667
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
002330
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002330
—
NY
Enumeration date
06/13/2019
Last updated
06/13/2019
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