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Individual

JENNIFER LEIGH INGRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
120 LAKES AT LITCHFIELD DR, PAWLEYS ISLAND, SC 29585-9001
(910) 228-6925
Mailing address
120 LAKES AT LITCHFIELD DR, PAWLEYS ISLAND, SC 29585-9001
(910) 228-6925

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3118
SC

Other

Enumeration date
10/11/2012
Last updated
10/22/2015
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