Individual
RYAN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1212 8TH ST STE 3, BARABOO, WI 53913-1875
(608) 448-2497
Mailing address
1217 DEBRA LN, MADISON, WI 53704-1416
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9604123
WI
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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