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1912381575
IMANI INGRAM
SOUTH BEND, IN
NPI
1912381575
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-07-14
Last Update Date
2015-07-14
Business Address
-- IMANI INGRAM MPA, ACIT
4218 W WESTERN AVE
SOUTH BEND, IN 46619-2622
Phone number: 574-233-1524
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Mailing Address
-- IMANI INGRAM MPA, ACIT
4218 W WESTERN AVE
SOUTH BEND, IN 46619-2622
Phone number: 574-233-1524
Copy
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