Provider Demographics
NPI:1851716179
Name:IVEY, EMILY (ND)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:IVEY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2068 VALLEYDALE RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2006
Mailing Address - Country:US
Mailing Address - Phone:205-588-9230
Mailing Address - Fax:
Practice Address - Street 1:2068 VALLEYDALE RD
Practice Address - Street 2:SUITE K
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2006
Practice Address - Country:US
Practice Address - Phone:205-588-9230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60432253175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath