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Individual

ELLEN A RYLANDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
339 REED AVE, MANITOWOC, WI 54220-2020
(920) 320-8600
(920) 320-8662
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
253-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104100000X
WI
01
29449
NETWORK HEALTH PLAN
01
S54451
CIGNA
Enumeration date
07/16/2006
Last updated
11/01/2011
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