NPI | 1003341371 |
---|---|
Former Name | A'LYECIA RUTH IVORY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2017-04-25 |
Last Update Date | 2024-06-19 |