Individual
BETTY IVORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6619 S DREXEL AVE, CHICAGO, IL 60637-7352
(312) 721-9101
Mailing address
6619 S DREXEL AVE, CHICAGO, IL 60637-7352
(312) 721-9101
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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