Individual
BROOKE BOUCHER INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 S CHURCH ST APT 336, CHARLOTTE, NC 28203-4186
(704) 891-6253
Mailing address
7 MCKENNA COMMONS CT, GREENVILLE, SC 29615-2633
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
893
NC
106E00000X
Assistant Behavior Analyst
0-19-9987
—
Other
Enumeration date
05/27/2018
Last updated
02/18/2025
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