Provider Demographics
NPI:1417963950
Name:RYAN, KATHARINA MARIA (CTRS)
Entity Type:Individual
Prefix:
First Name:KATHARINA
Middle Name:MARIA
Last Name:RYAN
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2920 SILVER LAKE CT NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3453
Mailing Address - Country:US
Mailing Address - Phone:612-467-3958
Mailing Address - Fax:612-727-5643
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:(135R)
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-3958
Practice Address - Fax:612-727-5643
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist