Individual
SEAN RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
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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