Provider Demographics
NPI:1114795242
Name:RYAN, LINDA JEAN
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JEAN
Last Name:RYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-2402
Mailing Address - Country:US
Mailing Address - Phone:508-479-8793
Mailing Address - Fax:
Practice Address - Street 1:848 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-2402
Practice Address - Country:US
Practice Address - Phone:508-479-8793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst