Individual
MRS. LAKISHA T INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A
Contact information
Practice address
168 GREENCASTLE DR, JACKSON, TN 38305
(731) 614-3572
(731) 668-0340
Mailing address
168 GREENCASTLE DR, JACKSON, TN 38305-3834
(731) 614-3572
(731) 668-0380
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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