Individual
TANA D INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
1840 E BROADWAY RD, TEMPE, AZ 85282-1614
(480) 495-0314
Mailing address
22072 E PECAN DR, QUEEN CREEK, AZ 85142-4895
(480) 495-0314
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86069798
—
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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