Individual
MR. RYAN EMILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(760) 637-4462
Mailing address
676 SW DEXTER CIR APT 204, LAKE CITY, FL 32025-5682
(760) 637-4462
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
17915
SC
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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