DIANE IVAN

MORAINE, OH
NPI1437403524
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: OH  E1287)
Additional Taxonomies104100000X Social Worker
(Licence: OH  S13067)
Enumeration Date2012-10-29
Last Update Date2012-10-29
Business Address
-- DIANE IVAN
3095 KETTERING BLVD
MORAINE, OH 45439-1983
Phone number: 937-293-8300
Mailing Address
-- DIANE IVAN
3095 KETTERING BLVD
MORAINE, OH 45439-1983
Phone number: 937-293-8300