Individual
MS. JILL MEREDITH INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1309 KEMPSVILLE RD, NORFOLK, VA 23502-2205
(757) 461-5001
Mailing address
4403 LISBON LN APT 203, VIRGINIA BEACH, VA 23462-3176
(757) 416-7870
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6095
NC
Other
Enumeration date
01/21/2008
Last updated
01/21/2008
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