Individual
MR. RYAN LEE THOMASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
2351 W 12 MILE RD, BERKLEY, MI 48072-1826
(248) 544-4006
(248) 544-4113
Mailing address
114 ORCHARD LAKE RD, PONTIAC, MI 48341-2244
(248) 858-7766
(248) 858-7201
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1883825
—
MI
Enumeration date
09/27/2007
Last updated
09/27/2007
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