Provider Demographics
NPI:1043902406
Name:RYAN, SHERRY K (OTA/L)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:K
Last Name:RYAN
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 INTERSTATE 35 N APT 515
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-8404
Mailing Address - Country:US
Mailing Address - Phone:210-219-3290
Mailing Address - Fax:
Practice Address - Street 1:770 INTERSTATE 35 N APT 515
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-8404
Practice Address - Country:US
Practice Address - Phone:210-219-3290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215363224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant