Individual
MARIA LOURDES INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5319 STAMPA AVE, LAS VEGAS, NV 89146-6853
(702) 253-5627
Mailing address
1528 LADY BRYAN LN, LAS VEGAS, NV 89110-1719
(702) 531-2739
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/27/2011
Last updated
12/27/2011
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