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1992956866
IVY MINK
BARLING, AR
NPI
1992956866
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Former Name
IVY MCRAE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2008-10-09
Last Update Date
2008-10-09
Business Address
-- IVY MINK MHPP/TEACHER
10301 MAYO DR
BARLING, AR 72923-1660
Phone number: 479-494-5700
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Mailing Address
-- IVY MINK MHPP/TEACHER
4253 N CROSSOVER RD
FAYETTEVILLE, AR 72703-4593
Phone number: 479-521-5731
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