Provider Demographics
NPI:1265792907
Name:RYERSON, NANCY ANNE
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANNE
Last Name:RYERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TRADECENTER STE 5900
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-7471
Mailing Address - Country:US
Mailing Address - Phone:781-249-5145
Mailing Address - Fax:978-304-1759
Practice Address - Street 1:400 TRADECENTER STE 5900
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-7471
Practice Address - Country:US
Practice Address - Phone:781-249-5145
Practice Address - Fax:978-304-1759
Is Sole Proprietor?:No
Enumeration Date:2012-05-28
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health