Provider Demographics
NPI:1932929544
Name:RYAN, DALEY (MS, LPC-MHSP)
Entity type:Individual
Prefix:
First Name:DALEY
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:MS, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3069 BROAD ST STE 7D
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-3083
Mailing Address - Country:US
Mailing Address - Phone:423-517-7070
Mailing Address - Fax:
Practice Address - Street 1:3069 BROAD ST STE 7D
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-3083
Practice Address - Country:US
Practice Address - Phone:423-517-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health