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1679006118
COREY INGRAM
COLUMBIA, SC
NPI
1679006118
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AL 11995)
Enumeration Date
2017-04-11
Last Update Date
2017-04-11
Business Address
Mr. COREY INGRAM LMSW
1409 DEVINE ST
COLUMBIA, SC 29208-3902
Phone number: 803-359-9871
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Mailing Address
Mr. COREY INGRAM LMSW
PO BOX 8745
COLUMBIA, SC 29202-8745
Phone number: 803-359-9871
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