Individual
TANIAH INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1732 BENJAMIN AVE NE, GRAND RAPIDS, MI 49505-5434
(616) 914-0795
Mailing address
1732 BENJAMIN AVE NE, GRAND RAPIDS, MI 49505-5434
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
374J00000X
Doula
Primary
—
MI
Other
Enumeration date
05/04/2018
Last updated
09/06/2024
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