Individual
BRENDA KAYE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W
Contact information
Practice address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
(310) 390-6612
Mailing address
302 E 45TH ST, LONG BEACH, CA 90807-1416
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS11609
CA
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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