Individual
CLARENCE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 LATROBE DR STE B, CHARLOTTE, NC 28211-5227
(704) 780-4271
Mailing address
12200 PAINTED TREE RD, CHARLOTTE, NC 28226-3851
(336) 745-0082
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NC
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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