Individual
CHRISTINA RENEE IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1166 GREENWAY DR, SUITE B5, JACKSON, MO 63755-2913
(573) 243-9900
(573) 243-5320
Mailing address
1166 GREENWAY DRIVE, SUITE B5, JACKSON, MO 63755
(573) 243-9900
(573) 243-5320
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2008009204
MO
Other
Enumeration date
11/24/2008
Last updated
11/24/2008
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