Provider Demographics
NPI:1700166832
Name:TOMAINO, RYAN ALAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:ALAN
Last Name:TOMAINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 AUCHMULL ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0212
Mailing Address - Country:US
Mailing Address - Phone:702-596-1073
Mailing Address - Fax:
Practice Address - Street 1:5426 VEGAS DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2403
Practice Address - Country:US
Practice Address - Phone:702-596-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-21
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical