Individual
RYAN CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
123 PIKE ST, PORT JERVIS, NY 12771-1824
(845) 854-7576
Mailing address
123 PIKE ST, PORT JERVIS, NY 12771-1824
(845) 856-7576
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20642
NY
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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