Individual
MR. KELLY TILMAN RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
945 19TH ST, DES MOINES, IA 50314-1117
(515) 241-0982
Mailing address
873 SE WILLIAMS CT, WAUKEE, IA 50263-8351
(515) 205-3731
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
05641
IA
1041C0700X
Clinical Social Worker
05641
IA
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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