Individual
MS. AMANDA RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1133 COLOMA WAY, C, ROSEVILLE, CA 95661-4480
(916) 774-6647
(916) 774-6456
Mailing address
1133 COLOMA WAY STE C, ROSEVILLE, CA 95661-4480
(209) 217-6413
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/04/2008
Last updated
01/11/2011
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