Individual
LESLIE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
270 COUNTY HOSPITAL RD, SUITE 109, QUINCY, CA 95971-9180
(530) 283-6307
Mailing address
2035 QUINCY JUNCTION RD, QUINCY, CA 95971-9310
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
687779
CA
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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