Individual
MITZI INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3455 WILKENS AVE LOWR LEVEL20, BALTIMORE, MD 21229-5213
(410) 646-6970
Mailing address
3455 WILKENS AVE LOWR LEVEL20, BALTIMORE, MD 21229-5213
(410) 646-6970
(410) 644-5609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADT3387
MD
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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