Provider Demographics
NPI:1295031821
Name:RYAN, KRYSTALEE B (BA)
Entity Type:Individual
Prefix:MS
First Name:KRYSTALEE
Middle Name:B
Last Name:RYAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 OAK ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4328
Mailing Address - Country:US
Mailing Address - Phone:413-734-0300
Mailing Address - Fax:
Practice Address - Street 1:7 OAK ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4328
Practice Address - Country:US
Practice Address - Phone:413-734-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-29
Last Update Date:2011-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst