Individual
MR. REUBEN JULIUS INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CBT
Contact information
Practice address
3200 NW 48TH ST, 201B, OKLAHOMA CITY, OK 73112-5900
(405) 905-7087
Mailing address
3816 NW 51ST ST, OKLAHOMA CITY, OK 73112-2046
(405) 569-2486
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009
PASTOR/COUNSELOR
OK
Enumeration date
09/24/2012
Last updated
09/24/2012
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