Individual
RACHEL SPENCER IVANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP
Contact information
Practice address
705 LANDA ST STE C, NEW BRAUNFELS, TX 78130-6163
(210) 360-1590
(210) 855-9300
Mailing address
4004 HALFWAY CV, ROUND ROCK, TX 78681-1005
(512) 591-6841
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
902941
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1030787
TX
Other
Enumeration date
12/03/2020
Last updated
10/03/2022
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