MARK ANTHONY INGRAM

TULSA, OK
NPI1417235425
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK  635)
Enumeration Date2011-07-25
Last Update Date2011-07-25
Business Address
-- MARK ANTHONY INGRAM LADC
7537 S BRADEN AVE
TULSA, OK 74136-8202
Phone number: 918-857-0269
Mailing Address
-- MARK ANTHONY INGRAM LADC
7537 S BRADEN AVE
TULSA, OK 74136-8202
Phone number: 918-857-0269
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