Ivy, Jeremy David

Ivy, Jeremy David is an individual health care provider with primary practice located at 148 Wilshire Blvd , Casselberry FL 32707-5372. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Ivy, Jeremy David can be contacted via phone (321) 972-4039.

Contact Information

Primary practice address
148 Wilshire Blvd Casselberry FL 32707-5372
Phone: (321) 972-4039
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-19-98379 Florida

Profile Details

NPI number 1356990766
LBN Legal business name Ivy, Jeremy David
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2019
Last updated Sep 27th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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