Individual
ELESIA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1125 SCHILLING BLVD E, COLLIERVILLE, TN 38017-7078
(901) 248-7440
Mailing address
1535 E SHELBY DR, MEMPHIS, TN 38116-7224
(901) 498-3118
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/28/2022
Last updated
02/28/2022
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