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1023636909
GARY SCOTT RALYA
FORT WAYNE, IN
NPI
1023636909
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IN 34002338A)
Enumeration Date
2020-07-08
Last Update Date
2020-07-08
Business Address
GARY SCOTT RALYA LCSW
2121 E STATE BLVD
FORT WAYNE, IN 46805-4640
Phone number: 260-426-5431
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Mailing Address
GARY SCOTT RALYA LCSW
5646 LAKE AVE
FORT WAYNE, IN 46815-7564
Phone number: 260-450-5683
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