Individual
RALPH C IBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
2450 E SHOW LOW LAKE RD, SUITE 3A, SHOW LOW, AZ 85901-7953
(928) 532-1069
Mailing address
2450 E SHOW LOW LAKE RD, SUITE 3A, SHOW LOW, AZ 85901-7953
(928) 532-1069
(602) 212-2005
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-0263
AZ
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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