Aubrey Ryan, LMFT | |
4740 N Clark St, Chicago, IL 60640-4689 | |
(773) 275-6946 | |
Not Available |
Full Name | Aubrey Ryan |
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Gender | Female |
Speciality | Marriage & Family Therapist |
Location | 4740 N Clark St, Chicago, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396080297 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | 166.001011 (Illinois) | Primary |
Entity Name | Bravura Therapy Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255951158 PECOS PAC ID: 5193161578 Enrollment ID: O20240307002108 |
Mailing Address | Practice Location Address |
---|---|
Aubrey Ryan, LMFT 4740 N Clark St, Chicago, IL 60640-4689 Ph: (773) 275-6946 | Aubrey Ryan, LMFT 4740 N Clark St, Chicago, IL 60640-4689 Ph: (773) 275-6946 |
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