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Individual
IVAN AYALA
Active
Individual
IVAN AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
23335
MN
106H00000X
Marriage & Family Therapist
Primary
2837
MN
Other
Enumeration date
12/17/2014
Last updated
04/07/2017
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