MEDICARE: RYANN KRETSCHMER

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	1041C0700X	Clinical Social Worker	12207803-3501	UT

General Provider Information

NPI Number	:	1326785957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYANN KRETSCHMER

Provider Business Mailing Address
First Line	:	2230 N UNIVERSITY PKWY STE 9D
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-1595
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 N UNIVERSITY PKWY STE 9D
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-1595
Country	:	US
Telephone Number	:	801-228-0656
Fax Number	:

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

Provider Enumeration Date	:	05/16/2022
Last Update Date	:	07/01/2025

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Directions to “ RYANN KRETSCHMER ” Practice Location

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