Individual
RYAN M ETTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-45249
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
45249
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437270097
ALL PRIVATE INS UTILIZED
ID
Enumeration date
10/26/2021
Last updated
12/19/2025
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