Organization
TARA RYAN LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA RYAN (LCSW)
(208) 982-6300
Entity
Organization
Contact information
Practice address
760 E WARM SPRINGS AVE, SUITE F, BOISE, ID 83712-6476
(208) 982-6300
Mailing address
760 E WARM SPRINGS AVE, SUITE F, BOISE, ID 83712-6476
(208) 982-6300
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
081479-1
NY
251S00000X
Community/Behavioral Health Agency
60450
TX
251S00000X
Community/Behavioral Health Agency
Primary
LCSW-34461
ID
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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