Individual
MS. JENNIFER L IVANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CGC
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 944-3966
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
74000173A
IN
170300000X
Genetic Counselor (M.S.)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300025506
—
IN
Enumeration date
01/17/2014
Last updated
05/31/2022
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