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1548608839
IVY HALL
FAIRFIELD, CA
NPI
1548608839
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Former Name
IVY PAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA 26490)
Enumeration Date
2013-06-07
Last Update Date
2018-04-18
Business Address
Dr. IVY HALL Ph.D.
103 BODIN CIR BLDG 778
FAIRFIELD, CA 94535-1801
Phone number: 707-437-1814
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Mailing Address
Dr. IVY HALL Ph.D.
103 BODIN CIR BLDG 778
FAIRFIELD, CA 94535-1801
Phone number:
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