Organization
FUNDAMENTALS PEDIATRIC THERAPY AND CONSULTING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIRSTEN ELISE RYAN MA LCPC (THERAPIST)
(847) 477-9816
Entity
Organization
Contact information
Practice address
215 S SPRINGSIDE DR, ROUND LAKE BEACH, IL 60073-8139
(847) 477-9816
(847) 574-8147
Mailing address
215 S SPRINGSIDE DR, ROUND LAKE BEACH, IL 60073-8139
(847) 477-9816
(847) 574-8147
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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