| NPI | 1922624816 |
|---|---|
| Professional Name | IVY NALLEY ROSHTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW007184) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA C0281) |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2024-01-03 |