Phoenix, Ivy Mare

Phoenix, Ivy Mare is an sole proprietor health care provider with primary practice located at 2965 W 3500 S , West Valley City UT 84119-3602. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Phoenix, Ivy Mare can be contacted via phone (801) 965-3608.

Contact Information

Primary practice address
2965 W 3500 S West Valley City UT 84119-3602
Phone: (801) 965-3608
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 11772649-6004 Utah

Profile Details

NPI number 1225668668
LBN Legal business name Phoenix, Ivy Mare
Credentials CMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 24th, 2020
Last updated Aug 31st, 2024 - about 2 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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