| Dallas Ivy Therapy And Wellness Services | |
|
298 Northwind Dr Stockbridge GA 30281-6216 | |
| (404) 934-8428 | |
| Not Available |
| Full Name | Dallas Ivy Therapy And Wellness Services |
|---|---|
| Speciality | Counselor - Professional |
| Location | 298 Northwind Dr, Stockbridge, Georgia |
| Authorized Official Name and Position | Lawanda Owens (OWNER) |
| Authorized Official Contact | 4049348428 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Ivy Therapy And Wellness Services 298 Northwind Dr Stockbridge GA 30281-6216 Ph: (404) 934-8428 | Dallas Ivy Therapy And Wellness Services 298 Northwind Dr Stockbridge GA 30281-6216 Ph: (404) 934-8428 |
| NPI Number | 1477320885 |
|---|---|
| Provider Enumeration Date | 12/06/2023 |
| Last Update Date | 12/06/2023 |
| Certification Date | 12/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477320885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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