Individual
TAKEYRA RAEDAWN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 WINLEY CHASE AVE, NORTH LAS VEGAS, NV 89032-1123
(702) 619-6884
Mailing address
205 WINLEY CHASE AVE, NORTH LAS VEGAS, NV 89032-1123
(702) 619-6884
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
NV
Other
Enumeration date
04/01/2013
Last updated
04/01/2013
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