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Individual
MR. REUBEN JULIUS INGRAM
Active
Individual
MR. REUBEN JULIUS INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CBT
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009
PASTOR/COUNSELOR
OK
Enumeration date
09/24/2012
Last updated
09/24/2012
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