Provider Demographics
NPI:1891924585
Name:GILES, RYAN (MSW)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:GILES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 SPANISH FIELDS DR
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-5733
Mailing Address - Country:US
Mailing Address - Phone:801-358-5586
Mailing Address - Fax:802-655-4954
Practice Address - Street 1:1443 W 800 N
Practice Address - Street 2:STE 103
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2878
Practice Address - Country:US
Practice Address - Phone:801-655-4950
Practice Address - Fax:801-655-4954
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-5741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical