Individual
CRYSTAL INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW-A
Contact information
Practice address
2555 PROMISE LAND RD, LA GRANGE, NC 28551-7004
(252) 481-1205
Mailing address
2555 PROMISE LAND RD, LA GRANGE, NC 28551-7004
(252) 481-1205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P010948
NC
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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