Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 1-12-11395 | MI |
Y | 102L00000X | Psychologist | 6301010239 | MI |
Y | 103T00000X | Psychologist | 6301010239 | MI |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6301010239 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301010239 | |
N | 103G00000X | Clinical Psychologist | 6301010239 | MI |
N | 103TC0700X | Clinical Psychologist | 6301010239 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 6301010239 | MI |
N | 103TP2701X | Group Psychotherapist | 6301010239 | MI |
NPI | 1407977697 |
---|---|
Provider Name | Dr. Lori Ann Ryland |
First Address | Battle Creek, MI 49017-9027 |
Second Address | Battle Creek, MI 49017-3602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 11/10/2012 |