Individual
IVY DOULIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 RIVER RD STE 14, HARRIMAN, NY 10926-3040
(520) 884-5863
Mailing address
PO BOX 760, CORNWALL, NY 12518-0760
(845) 275-2541
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-180538
NY
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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