Individual
IVY DAEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
770 TAMALPAIS DR STE 410, CORTE MADERA, CA 94925-1739
(154) 925-1822
Mailing address
2501 COTTONTAIL LN, SOMERSET, NJ 08873-5125
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
04/16/2024
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