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Individual

KRISTIN LIV RYDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
4201 LAKE BOONE TRAIL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Mailing address
4201 LAKE BOONE TRAIL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6832
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140H2
BCBS
NC
01
182399
MEDCOST
01
4600072
UNITED HEALTHCARE
05
7412360
NC
01
7721743
AETNA
05
8300041K
NC
Enumeration date
12/22/2006
Last updated
07/09/2007
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