Individual
TARA J RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4696 W OVERLAND RD, SUITE 252, BOISE, ID 83705-2845
(208) 345-9300
Mailing address
4696 W OVERLAND RD, SUITE 252, BOISE, ID 83705-2845
(208) 345-9300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/04/2008
Last updated
09/19/2015
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