Individual
OLIVIA IVANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP, BCBA
Contact information
Practice address
14973 MANCROFT DR, FISHERS, IN 46037-5513
(317) 490-9305
Mailing address
2 N CENTRAL AVE, PHOENIX, AZ 85004-2322
(463) 777-8323
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
235Z00000X
Speech-Language Pathologist
Primary
46002644A
IN
Other
Enumeration date
10/07/2014
Last updated
02/05/2024
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