Provider Demographics
NPI:1093524621
Name:FERGER, IVY RYAN
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:RYAN
Last Name:FERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 ALLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2522
Mailing Address - Country:US
Mailing Address - Phone:410-777-0715
Mailing Address - Fax:
Practice Address - Street 1:806 LANDMARK DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4980
Practice Address - Country:US
Practice Address - Phone:443-375-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician