Most Relevant Information
Provider Data
| NPI Number: | 1003367319 |
| Provider Name: | SEAN RYAN LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | SW11876 |
Most Important Dates
| Enumeration Date: | 10/21/2016 |
| Last Updated: | 09/26/2017 |
Provider Practice Location
56 OLD FARM RD
STOWE
VT
056724434
Practice Location Phone/Fax
| Phone: | 8024334134 |
| Fax: |
Provider Mailing Location
40 TAMARACK LN
WATERBURY CENTER
VT
056774415
Provider Mailing Phone/Fax
| Phone: | 8024334134 |
| Fax: |