Individual
DALE RYDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4715 S PONDEROSA PARK RD, PRESCOTT, AZ 86303-6146
(928) 925-3191
Mailing address
4715 S PONDEROSA PARK RD, PRESCOTT, AZ 86303-6146
(928) 925-3191
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW10344
AZ
Other
Enumeration date
01/01/2010
Last updated
01/01/2010
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