Individual
JAMESENA INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. ED.
Contact information
Practice address
518 IRVIN ST, PLYMOUTH, MI 48170-1113
(734) 740-0563
Mailing address
518 IRVIN ST, PLYMOUTH, MI 48170-1113
(734) 740-0563
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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