Individual
MR. BENJAMIN W. J. INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2528 NW 109TH ST, OKLAHOMA CITY, OK 73120-7118
(405) 981-7091
(405) 228-7047
Mailing address
2528 NW 109TH ST, OKLAHOMA CITY, OK 73120-7118
(405) 981-7091
(405) 228-7047
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EF999447760
NONE
OK
Enumeration date
10/03/2022
Last updated
10/03/2022
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