MEDICARE: RYAN MCNAMARA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1003665076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN MCNAMARA

Provider Business Mailing Address
First Line	:	10123 HIGH RANGE RD SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87121-2145
Country	:	US
Telephone Number	:	831-334-3525
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 HIGHWAY 314 NE
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-8506
Country	:	US
Telephone Number	:	505-944-6626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2024
Last Update Date	:	05/21/2024

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Directions to “ RYAN MCNAMARA ” Practice Location

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