Ivy E. Assenberg, LPC
Counselor, Professional in Jackson, WY. Individual provider (NPI-1).
NPI number1760635940
StatusActive
Last updated in NPPESFeb 26, 2020
Details
- NPI
- 1760635940
- Entity type
- Individual (NPI-1)
- Name
- Ivy E. Assenberg
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 31, 2008
- Certification date
- Feb 26, 2020
- Last updated
- Feb 26, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | LPC-420 | WY | Yes |
Practice location
640 East BroadwayJackson, WY 83001-1868
Phone 307-733-2046 · Fax 307-733-6289
Mailing address
Po Box 1868640 East Broadway
Jackson, WY 83001-1868
Phone 307-733-2046 · Fax 307-733-6289
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