Diane Ivan

NPI #1437403524 in Moraine, Ohio

Provider Information

NPI Number: 1437403524
Entity Type: Individual
Name: Diane Ivan
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Enumeration Date: Oct 29, 2012
Last Updated: Oct 29, 2012

Practice Location

Address: 3095 KETTERING BLVD
City: Moraine
State: Ohio
ZIP Code: 45439-1983
Phone: (937) 293-8300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary
Social Worker	104100000X

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