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Individual

MR. RYAN BRYCE TARANTINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
15 UNION ST STE 200, LAWRENCE, MA 01840-1823
(978) 682-7289
Mailing address
110 BOSTON ST, SALEM, MA 01970-1402

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
103T00000X
Psychologist
104100000X
Social Worker
Primary

Other

Enumeration date
08/23/2021
Last updated
08/23/2021
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