Individual
RYAN MATTHEW BOURDEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8069
(813) 272-3766
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8069
(813) 272-3766
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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