Individual
DOMINIC GIAFAGLEONE RYADDIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3225 HEDLEY RD, SPRINGFIELD, IL 62711-6248
(217) 726-7300
(217) 726-5989
Mailing address
3225 HEDLEY RD, SPRINGFIELD, IL 62711-6248
(217) 726-7300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.023139
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149023139
LCSW
IL
Enumeration date
02/03/2022
Last updated
11/30/2023
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