Individual
IVY GWEN PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 UNION DR STE 206, LINCOLN, NE 68516-6652
(402) 432-4372
Mailing address
1016 B ST APT 10, LINCOLN, NE 68502-1242
(402) 875-8865
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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