Individual
IVY MORGAN WALLERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 W 13TH ST, NORTH PLATTE, NE 69101-7202
(402) 853-4995
Mailing address
1515 W 13TH ST, NORTH PLATTE, NE 69101-7202
(308) 641-7891
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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