Individual
DR. BHANUMATHI IVATURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LCSW
Contact information
Practice address
1422 LINCOLN DR, CARROLLTON, TX 75500-1400
(972) 245-4192
Mailing address
1422 LINCOLN DR, CARROLLTON, TX 75500-1400
(972) 245-4192
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2893
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00S7UT
BCBS TX
—
05
—
LP0008754
—
TX
Enumeration date
04/18/2007
Last updated
07/08/2007
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