Individual
MRS. TAMMI RENEE IVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MRC, LPC
Contact information
Practice address
3358 SUITE D. S. 2ND STREET, CABOT, AR 72023
(501) 286-6053
(870) 523-9301
Mailing address
620 EDWARDS ST, NEWPORT, AR 72112-9074
(870) 926-2840
(870) 523-9301
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0411049
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169387795
—
AR
Enumeration date
12/31/2008
Last updated
02/21/2018
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