Individual
MR. IVAN RONNIE QUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
207 W ANTRIM DR, GREENVILLE, SC 29607-2329
(864) 302-5926
Mailing address
207 W ANTRIM DR, GREENVILLE, SC 29607-2329
(864) 614-1407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-23688
NC
101YP2500X
Professional Counselor
Primary
8240
SC
Other
Enumeration date
04/30/2020
Last updated
03/31/2023
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