| Doctor Name: | MINOU RYSIEW |
| NPI Number: | 1154472413 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W. |
| License Number: | CSW003390 |
| Business Practice Address: | 1551 Jennings Mill Rd Unit 3200a Resource Valley Watkinsville, GA - 306777282 |
| Business Phone Number: | 7062076611 |
| Business Fax Number: | |
| Mailing Address: | 490 Maple Forge Dr, ATHENS |
| State: | GA |
| Postal Code: | 306061166 |
| Phone Number: | 7062076611 |
| Fax Number: | |
| NPI Enumeration Date: | 01/15/2007 |
| NPI Last Update Date: | 03/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CSW003390 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |