Individual
CAROL RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 W HIGH ST, ELKHART, IN 46516-2827
(574) 262-3597
(574) 262-3599
Mailing address
4000 E BRISTOL ST STE 3-284, ELKHART, IN 46514-6949
(574) 596-6404
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001596A
IN
101YP2500X
Professional Counselor
6401015237
MI
Other
Enumeration date
01/28/2017
Last updated
03/31/2020
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