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1316488117
LAKISHA T INGRAM
JACKSON, TN
NPI
1316488117
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-03-13
Last Update Date
2017-03-13
Business Address
Mrs. LAKISHA T INGRAM B.A
168 GREENCASTLE DR
JACKSON, TN 38305
Phone number: 731-614-3572
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Mailing Address
Mrs. LAKISHA T INGRAM B.A
168 GREENCASTLE DR
JACKSON, TN 38305-3834
Phone number: 731-614-3572
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