Individual
NICOLE J RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4622 JERICHO RD, VIRGINIA BEACH, VA 23462-2225
(757) 648-3320
Mailing address
40 ROSE AVE, SPRINGFIELD, NJ 07081-1721
(908) 358-8595
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010723
VA
235Z00000X
Speech-Language Pathologist
2204000794
VA
Other
Enumeration date
08/11/2021
Last updated
03/27/2026
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