Individual
JORDAN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2508 SE 20TH ST, BENTONVILLE, AR 72712-4008
(479) 273-9088
(479) 845-2111
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 725-5115
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10066M
AR
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/31/2020
Last updated
04/10/2023
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