Individual
GUION LARON INGRAM SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
945 FAWCETT AV, TACOMA, WA 98402-5612
(253) 207-4301
Mailing address
721 FAWCETT AVE, TACOMA, WA 98402-5502
(253) 207-4301
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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