| NPI | 1619360617 |
|---|---|
| Former Name | IVY HUMPHREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401017786) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401017786) |
| Enumeration Date | 2015-03-15 |
| Last Update Date | 2022-04-30 |