Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | NC |
NPI | 1003400300 |
---|---|
Provider Name | Debbie S Ivy |
First Address | Durham, NC 27707-3757 |
Second Address | Durham, NC 27707-3757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2021 |
Last Update Date | 26/02/2021 |