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General NPI Number Information
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NPI Number | 1528392719
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Entity Type | Individual
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Provider Name | RYA MCCANN LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 1750 E GRAND RIVER AVE STE 101
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City | EAST LANSING
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State | MI
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Zip | 48823-4958
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Country | US
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Telephone | 517-258-0414
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Fax |
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Provider Business Mailing Address
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Address Line | 205 LOREE DR
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City | EAST LANSING
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State | MI
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Zip | 48823-1924
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 007257
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801099224
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License Number State | MI
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