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General NPI Number Information
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NPI Number | 1891736211
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Entity Type | Individual
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Provider Name | TRESSA RENEE RYAN MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 680 CENTRAL AVE STE 103
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City | DOVER
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State | NH
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Zip | 03820-3495
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Country | US
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Telephone | 603-964-1700
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Fax | 603-749-7502
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Provider Business Mailing Address
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Address Line | 165 DEER HILL RD
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City | BRENTWOOD
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State | NH
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Zip | 03833-6600
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Country | US
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Telephone | 603-964-1700
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 126906
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | NH819
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License Number State | NH
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