Individual
MS. IVY GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2839 31ST PL NE, WASHINGTON, DC 20018-1603
(202) 751-8579
Mailing address
2839 31ST PL NE, WASHINGTON, DC 20018-1603
(202) 751-8579
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19419
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19419
SOCIAL WORK LICENSE
MD
01
—
50078633
SOCIAL WORK LICENSE
DC
Enumeration date
06/22/2021
Last updated
06/22/2021
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