NPI | 1154338820 |
---|---|
Other Name | DAVID CHARLES IVEY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 25097) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 3012) |
Enumeration Date | 2006-08-02 |
Last Update Date | 2012-03-01 |