Healthcare Provider Details

I. General information

NPI: 1386663888
Provider Name (Legal Business Name): PATRICK DENNIS RYAN L.I.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PATRICK DENNIS RYAN L.I.S.W.

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 SLABTOWN RD
LIMA OH
45801-3307
US

IV. Provider business mailing address

2041 SLABTOWN RD
LIMA OH
45801-3307
US

V. Phone/Fax

Practice location:
  • Phone: 419-225-7157
  • Fax: 419-225-5850
Mailing address:
  • Phone: 419-225-7157
  • Fax: 419-225-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0003966
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: