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Individual

MRS. TINA BAKER IVEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRC

Contact information

Practice address
420 ACADEMY AVE, DUBLIN, GA 31021-5222
(478) 275-0679
(478) 275-0913
Mailing address
907 HIGHLAND AVE, DUBLIN, GA 31021-4815
(478) 275-0679
(478) 275-0913

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
GA

Other

Enumeration date
04/05/2007
Last updated
07/08/2007
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