Individual
JENNIFER DIANE RYALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1087 WARWICK AVE, WARWICK, RI 02888-3545
(401) 461-6676
(401) 461-3165
Mailing address
212 GLENWOOD AVE, PAWTUCKET, RI 02860-5939
(401) 461-6676
(401) 461-3165
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01803
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1021740
NHP GROUP NUMBER
—
01
—
319458
BCBS
RI
01
—
413750
BLUE CHIP
RI
05
—
JR62069
—
RI
Enumeration date
01/08/2007
Last updated
05/06/2011
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