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Individual

SUSAN LYNN INGRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
8182 SEQUOIA LN, WHITE LAKE, MI 48386-3594
(248) 807-1042
Mailing address
8182 SEQUOIA LN, WHITE LAKE, MI 48386-3594
(248) 807-1042

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
7101001841
MI
235Z00000X
Speech-Language Pathologist
Primary
MI

Other

Enumeration date
04/08/2021
Last updated
04/08/2021
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