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Organization
IVY BEHAVIORAL GROUP INC
Active
Organization
IVY BEHAVIORAL GROUP INC
Active
Other names
Ivy Behavioral Group
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY GOSSER IVY BCBA (CEO/OWNER)
(772) 208-0071
Entity
Organization
Contact information
Practice address
2336 SE OCEAN BLVD # 167, STUART, FL 34996-3310
(772) 208-0071
(772) 213-9558
Mailing address
1437 DENVER AVE # 157, LOVELAND, CO 80538-5226
(772) 208-0071
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
1-12-11892
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023921300
—
FL
Enumeration date
02/07/2018
Last updated
05/06/2021
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