Individual
RAVEN CHYANNE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
214 AIRPORT RD, CLEARFIELD, PA 16830-6126
(814) 591-8947
Mailing address
214 AIRPORT RD, CLEARFIELD, PA 16830-6126
(814) 591-8947
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
PA
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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