Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | R0429 | MO |
N | 103TC1900X | Counseling Psychologist | R0429 | MO |
N | 103TF0000X | Family Psychologist | R0429 | MO |
NPI | 1114108263 |
---|---|
Provider Name | Mrs. Linda Christine Ryan |
First Address | Grandview, MO 64030-3659 |
Second Address | Grandview, MO 64030-3659 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2007 |
Last Update Date | 16/11/2007 |