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Individual

IVY MARE PHOENIX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMHC

Contact information

Practice address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3608
Mailing address
1375 N SCOTTSDALE RD STE 200, SCOTTSDALE, AZ 85257-3429
(480) 877-9284

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11772649-6004
UT

Other

Enumeration date
01/24/2020
Last updated
08/31/2024
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