Most Relevant Information
Provider Data
| NPI Number: | 1003312471 |
| Provider Name: | KIMBERLY RAE RYAN |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/03/2018 |
| Last Updated: | 04/03/2018 |
Provider Practice Location
176 FRANKLIN ST
LYNN
MA
019043230
Practice Location Phone/Fax
| Phone: | 7815932727 |
| Fax: |
Provider Mailing Location
176 FRANKLIN ST
LYNN
MA
019043230
Provider Mailing Phone/Fax
| Phone: | 7815932727 |
| Fax: |