Provider Demographics
NPI:1497808430
Name:RYAN, BERNICE MARTHA (M A CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:BERNICE
Middle Name:MARTHA
Last Name:RYAN
Suffix:
Gender:F
Credentials:M A CCC-SLP
Other - Prefix:
Other - First Name:BERNICE
Other - Middle Name:MARTHA
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:3 BANBURY CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2612
Mailing Address - Country:US
Mailing Address - Phone:267-784-1727
Mailing Address - Fax:215-860-1392
Practice Address - Street 1:3 BANBURY CT
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-2612
Practice Address - Country:US
Practice Address - Phone:267-784-1727
Practice Address - Fax:215-860-1392
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NVSP-4146235Z00000X
NY012319-1235Z00000X
CASP 23674235Z00000X
PASL018332235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist