Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11159274 |
NPI | 1326439712 |
---|---|
Provider Name | Ms. Kerry Michele Ryan |
First Address | Norwalk, CT 06850-1610 |
Second Address | Norwalk, CT 06850-1610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2015 |
Last Update Date | 06/02/2015 |