Individual
CHAQUITA INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COUNSELOR
Contact information
Practice address
2690 SOMERSET DR APT Z307, LAUDERDALE LAKES, FL 33311-9475
(561) 709-9436
Mailing address
2690 SOMERSET DR APT Z307, LAUDERDALE LAKES, FL 33311-9475
(561) 709-9436
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
FTCA-CLI-1024-430
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FTCA-CLI-1024-430
PASTORAL LICENSE
FL
Enumeration date
05/02/2022
Last updated
05/11/2022
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