Organization
RESILIENT THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL INGRAM LPC (OWNER)
(804) 592-1097
Entity
Organization
Contact information
Practice address
4932 DOMINION BLVD, GLEN ALLEN, VA 23060-6714
(804) 592-1097
(804) 592-1097
Mailing address
4932 DOMINION BLVD, GLEN ALLEN, VA 23060-6714
(804) 592-1097
(804) 592-1097
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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