Individual
RYAN DELAWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1217 1ST ST NW, ALBUQUERQUE, NM 87102-1529
(505) 766-5197
Mailing address
PO BOX 25445, ALBUQUERQUE, NM 87125-0445
(505) 766-5197
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31477232
—
NM
Enumeration date
12/20/2013
Last updated
12/22/2021
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