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Individual

SEAN RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
56 OLD FARM RD, STOWE, VT 05672-4434
(802) 433-4134
Mailing address
40 TAMARACK LN, WATERBURY CENTER, VT 05677-4415
(802) 433-4134

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0122958
VT
1041C0700X
Clinical Social Worker
SW11876
FL

Other

Enumeration date
10/21/2016
Last updated
09/26/2017
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