Individual
KERRY RYALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2003 SE WALTON BLVD, BENTONVILLE, AR 72712-3725
(479) 750-2020
(479) 750-4843
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0111361
NM
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
P1706315
AR
106H00000X
Marriage & Family Therapist
61118
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M1925
—
NM
Enumeration date
06/18/2009
Last updated
03/17/2018
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