Basic Information
| Provider Information | |||||||||
| NPI: | 1215167127 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RYERSON | ||||||||
| FirstName: | GERALYN | ||||||||
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| Credential: | LPCMH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5177 W WOODMILL DR | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198084067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029998426 | ||||||||
| FaxNumber: | 3029998761 | ||||||||
| Practice Location | |||||||||
| Address1: | 1601 MILLTOWN RD | ||||||||
| Address2: | SUITE 8 | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198084027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025473060 | ||||||||
| FaxNumber: | 3025473060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2009 | ||||||||
| LastUpdateDate: | 08/27/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | PC-0000470 | DE | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 101YP2500X | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.