Individual
SHIRLEY DIANNE IVIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 SAN ERNESTO AVE, ANCHORAGE, AK 99508-2874
(907) 729-5020
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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