Individual
IVEY HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2118 SANDY LN, LAUREL, MS 39443-9087
(601) 342-2923
Mailing address
4805 W 4TH ST, HATTIESBURG, MS 39402-1019
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S4676
MS
Other
Enumeration date
07/29/2021
Last updated
07/31/2024
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