Provider Demographics
NPI:1851765853
Name:RYAN, PATRICIA LYNN (MA)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LYNN
Last Name:RYAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:304 MAIN AVE.
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-6144
Mailing Address - Country:US
Mailing Address - Phone:202-688-7143
Mailing Address - Fax:877-637-7491
Practice Address - Street 1:304 MAIN AVE.
Practice Address - Street 2:SUITE 208
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-6144
Practice Address - Country:US
Practice Address - Phone:202-688-7143
Practice Address - Fax:877-637-7491
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-15
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14718101YP2500X
CT4952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional