Provider Demographics
NPI:1831746270
Name:RYAN, CARA JOY (MA, SLP)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:JOY
Last Name:RYAN
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 SUBSTATION RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-1903
Mailing Address - Country:US
Mailing Address - Phone:440-334-4939
Mailing Address - Fax:
Practice Address - Street 1:2401 W PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-6518
Practice Address - Country:US
Practice Address - Phone:440-885-2433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-14419235Z00000X
OHCOND.20191045-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist