Individual
MRS. KIRSTEN ELISE RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT, LCPC
Contact information
Practice address
215 S SPRINGSIDE DR, ROUND LAKE BEACH, IL 60073-8139
(847) 477-9816
(847) 740-1749
Mailing address
215 S SPRINGSIDE DR, ROUND LAKE BEACH, IL 60073-8139
(847) 477-9816
(847) 740-1749
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.007497
IL
222Q00000X
Developmental Therapist
Primary
KR42150502P
IL
Other
Enumeration date
01/15/2007
Last updated
11/11/2010
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