Provider Demographics
NPI:1588079974
Name:KOVAL, RYANN (LPCA)
Entity type:Individual
Prefix:MISS
First Name:RYANN
Middle Name:
Last Name:KOVAL
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2196
Mailing Address - Country:US
Mailing Address - Phone:919-557-6871
Mailing Address - Fax:
Practice Address - Street 1:301 SUNSET DR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2196
Practice Address - Country:US
Practice Address - Phone:919-557-6871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10709101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor