Individual
DORDANA ELIZABETH INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
901 W JEFFERSON ST, SPRINGFIELD, IL 62702-4833
(217) 545-8000
(217) 545-2275
Mailing address
901 W JEFFERSON ST, PO BOX 19642, SPRINGFIELD, IL 62702-4833
(217) 545-8000
(217) 545-2275
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-005400
IL
Other
Enumeration date
12/01/2009
Last updated
04/10/2014
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