Provider Demographics
NPI:1770089195
Name:BRANCH, RYANN (LCSWA)
Entity type:Individual
Prefix:MRS
First Name:RYANN
Middle Name:
Last Name:BRANCH
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 COURTNEY CREEK BLVD APT 1018
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1674
Mailing Address - Country:US
Mailing Address - Phone:336-267-3924
Mailing Address - Fax:
Practice Address - Street 1:3824 BARRETT DR STE 105
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7220
Practice Address - Country:US
Practice Address - Phone:919-790-7775
Practice Address - Fax:919-790-9755
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP011800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker