Individual
MS. LAURA ELIZABETH IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1258 HIGH ST, EUGENE, OR 97401-3238
(541) 342-8437
Mailing address
3457 MAHLON AVE, EUGENE, OR 97401-5861
(541) 206-8348
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6344
OR
Other
Enumeration date
06/08/2010
Last updated
05/17/2016
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