Individual
MS. MAKEDRA O'SHUN IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 MANOR STREET, MARION, AR 72364-9522
(870) 739-6818
(870) 739-1970
Mailing address
1886 WALL ST APT 7, MEMPHIS, TN 38134-9621
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
07/25/2008
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