Most Relevant Information
Provider Data
| NPI Number: | 1003247305 |
| Provider Name: | IVY B GROSS LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 118243 |
Most Important Dates
| Enumeration Date: | 12/12/2013 |
| Last Updated: | 03/21/2023 |
Provider Practice Location
43 JACKSON RD # 2
SOMERVILLE
MA
021452908
Practice Location Phone/Fax
| Phone: | 9544655478 |
| Fax: |
Provider Mailing Location
43 JACKSON RD
SOMERVILLE
MA
021452908
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |