Provider Demographics
NPI:1326378993
Name:PACE, IVRA YVETTE (MA, LPCI)
Entity Type:Individual
Prefix:MS
First Name:IVRA
Middle Name:YVETTE
Last Name:PACE
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Gender:F
Credentials:MA, LPCI
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Mailing Address - Street 1:1376 TIGER BLVD STE 210
Mailing Address - Street 2:CANNON PSYCHOLOGICAL ASSOCIATES
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631
Mailing Address - Country:US
Mailing Address - Phone:864-654-7848
Mailing Address - Fax:864-654-5777
Practice Address - Street 1:1376 TIGER BLVD STE 210
Practice Address - Street 2:CANNON PSYCHOLOGICAL ASSOCIATES
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2654
Practice Address - Country:US
Practice Address - Phone:864-654-7848
Practice Address - Fax:864-654-5777
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2014-03-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health