Doctor Name: | MR. GARRETT COLLINS RYAN |
NPI Number: | 1013170935 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMSW |
License Number: | 077362-1 |
Business Practice Address: | 6714 41st Ave Woodside, NY - 113773790 |
Business Phone Number: | 7184584243 |
Business Fax Number: | |
Mailing Address: | 5026 64th St, WOODSIDE |
State: | NY |
Postal Code: | 113775805 |
Phone Number: | 3474514070 |
Fax Number: | |
NPI Enumeration Date: | 07/10/2008 |
NPI Last Update Date: | 05/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 077362-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |