Individual
IVY DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
7220 W JEFFERSON AVE STE 202, LAKEWOOD, CO 80235-2023
(303) 225-7673
Mailing address
17031 BENNETT DR, PARKER, CO 80134-9118
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-46145
CO
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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