Individual
IVY JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 890-3553
(229) 891-9323
Mailing address
PO BOX 40, MOULTRIE, GA 31776-0040
(229) 890-3553
(229) 890-3557
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009474
GA
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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