Organization
MICHELLE INGRAM-SMITH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE INGRAM-SMTH (LICENSED INDEPENDENT PRACTITIONER)
(803) 476-2533
Entity
Organization
Contact information
Practice address
6221 MONTICELLO RD, COLUMBIA, SC 29203-2910
(803) 814-1091
Mailing address
6221 MONTICELLO RD, COLUMBIA, SC 29203-2910
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10827
SC
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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