| NPI | 1720509292 |
|---|---|
| Former Name | IVY ELLEN JEAN STURGEN (PREVIOUS) (MARRIED NAME) |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15687-132) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-07-21 |