Individual
EDDIE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
610 W. BROADWAY SUITES, SUITE L1, JACKSON, WY 83001
(307) 733-3908
(307) 734-0017
Mailing address
PO BOX 11390, JACKSON, WY 83002-1390
(307) 733-3908
(307) 734-0017
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
527
WY
Other
Enumeration date
12/24/2009
Last updated
12/24/2009
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