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Individual

MR. COREY INGRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
1409 DEVINE ST, COLUMBIA, SC 29208-3902
(803) 359-9871
Mailing address
PO BOX 8745, COLUMBIA, SC 29202-8745
(803) 359-9871

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11995
AL

Other

Enumeration date
04/11/2017
Last updated
04/11/2017
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