Organization
FUNDAMENTALS PEDIATRIC THERAPY AND CONSULTING INC.
Active
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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