Provider Demographics
NPI:1932973419
Name:DUBLIN RYAN, LEERAN BLYTHE (PHD, MS, CGC)
Entity Type:Individual
Prefix:
First Name:LEERAN
Middle Name:BLYTHE
Last Name:DUBLIN RYAN
Suffix:
Gender:F
Credentials:PHD, MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 CHILDRENS XRD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5594
Mailing Address - Country:US
Mailing Address - Phone:614-722-3063
Mailing Address - Fax:
Practice Address - Street 1:575 CHILDRENS XRD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5594
Practice Address - Country:US
Practice Address - Phone:614-722-3063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000822170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS