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Individual

DONNA LYNN IVERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4680 MONICA ST, WILDWOOD, FL 32163-0516
(630) 272-0546
Mailing address
P O BOX 1632, WILDWOOD, FL 34785

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149000854
IL
1041C0700X
Clinical Social Worker
Primary
14900854
IL
1041C0700X
Clinical Social Worker

Other

Enumeration date
05/10/2023
Last updated
05/10/2023
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