Individual
IVY DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSW
Contact information
Practice address
2960 RODEO PARK DR W, SANTA FE, NM 87505-6351
(505) 986-9633
(505) 820-1209
Mailing address
1400A BISHOPS LODGE RD, SANTA FE, NM 87506-0003
(505) 995-9954
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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