Provider Demographics
NPI:1154755957
Name:RYAN, KALIE LOUISE (AUD)
Entity type:Individual
Prefix:
First Name:KALIE
Middle Name:LOUISE
Last Name:RYAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KALIE
Other - Middle Name:LOUISE
Other - Last Name:STONEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:34 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6001
Mailing Address - Country:US
Mailing Address - Phone:207-707-5614
Mailing Address - Fax:
Practice Address - Street 1:34 CENTER ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6001
Practice Address - Country:US
Practice Address - Phone:207-707-5614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT537231H00000X
MEAD3437237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist