Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner | 73559 |
NPI | 1194327999 |
---|---|
Provider Name | Catherine Ivie |
First Address | Albuquerque, NM 87108-5180 |
Second Address | Albuquerque, NM 87108-5180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2020 |
Last Update Date | 16/11/2020 |