Most Relevant Information
Provider Data
| NPI Number: | 1003535006 |
| Provider Name: | IVY BYUN PHD, LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 74711 |
Most Important Dates
| Enumeration Date: | 08/23/2022 |
| Last Updated: | 08/25/2022 |
Provider Practice Location
6300 JOHN RYAN DR
FORT WORTH
TX
761324122
Practice Location Phone/Fax
| Phone: | 8179226000 |
| Fax: | 8179225955 |
Provider Mailing Location
6300 JOHN RYAN DR
FORT WORTH
TX
761324122
Provider Mailing Phone/Fax
| Phone: | 8179226000 |
| Fax: | 8179225955 |