Provider Demographics
NPI:1669037248
Name:ATTOBRA, IVY KONADU (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:IVY
Middle Name:KONADU
Last Name:ATTOBRA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 GEORGETOWN LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN EST
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2506
Mailing Address - Country:US
Mailing Address - Phone:301-213-2471
Mailing Address - Fax:
Practice Address - Street 1:1947 GEORGETOWN LN
Practice Address - Street 2:
Practice Address - City:HOFFMAN EST
Practice Address - State:IL
Practice Address - Zip Code:60169-2506
Practice Address - Country:US
Practice Address - Phone:301-213-2471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2258802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry