Individual
LEAH IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 GREGORY ST, UNION, SC 29379-2008
(864) 251-2732
Mailing address
112 GREGORY ST, UNION, SC 29379-2008
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-156576
SC
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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