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1003966474
TIMOTHY LEON INGRAM
JACKSONVILLE, FL
NPI
1003966474
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH1575)
Enumeration Date
2007-01-10
Last Update Date
2009-06-19
Business Address
Mr. TIMOTHY LEON INGRAM M.Ed.
9951 ATLANTIC BLVD STE 170
JACKSONVILLE, FL 32225-6584
Phone number: 904-482-4105
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Mailing Address
Mr. TIMOTHY LEON INGRAM M.Ed.
113 PINE ST
NEPTUNE BEACH, FL 32266-6050
Phone number: 904-249-5439
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