Individual
SEAN RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
20 ADMIN RD, BRIDGEWATER, MA 02324-3230
(508) 279-4500
Mailing address
5 RUSSELL AVE, PLYMOUTH, MA 02360-4039
(401) 440-4954
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
10378
MA
103T00000X
Psychologist
3628
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10378
PSYCHOLOGY LICENSE
MA
01
—
3628
PSYCHOLOGY LICENSE
CT
Enumeration date
05/23/2018
Last updated
05/23/2018
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