Individual
SHANNON MARIE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 FAIRFIELD AVE, BRIDGEPORT, CT 06604-4252
(203) 394-6529
Mailing address
60 FORBES PL, EAST HAVEN, CT 06512-2225
(203) 415-0059
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13646468
CT
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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