Individual
MR. OWEN D RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
52 CHARLTON ST, SOUTHBRIDGE, MA 01550-1910
(508) 765-9101
(508) 764-4389
Mailing address
44 BRIGHAM RD, WORCESTER, MA 01609-1006
(508) 799-6779
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
106261
MA
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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