Individual
ALAN IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3625 W MAIN ST, SUITE 100, NORMAN, OK 73072-4656
(405) 579-7560
Mailing address
3100 RED ROCK DR, OKLAHOMA CITY, OK 73165-7377
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1051
OK
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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