Individual
IVY MARIE MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
290 W EXCHANGE ST #101, PROVIDENCE, RI 02903
(401) 214-2330
Mailing address
290 W EXCHANGE ST #101, PROVIDENCE, RI 02903
(401) 214-2330
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
059797667
GA
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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