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1750800413
TARA LYNN IVANKOVICH
SLIDELL, LA
NPI
1750800413
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
Additional Taxonomies
1041C0700X Social Worker, Clinical
Enumeration Date
2017-09-14
Last Update Date
2017-09-14
Business Address
TARA LYNN IVANKOVICH LMSW
115 CHRISTIAN LN
SLIDELL, LA 70458-1350
Phone number: 985-690-6622
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Mailing Address
TARA LYNN IVANKOVICH LMSW
4055 LE MANS DR
MARRERO, LA 70072-6245
Phone number:
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