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Individual

GRANT INGRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.ED, BCBA

Contact information

Practice address
2032 W HARRIS AVE, SAN ANGELO, TX 76901-3806
(325) 320-3204
Mailing address
6026 WINNERS CIR, SAN ANGELO, TX 76904-9368
(325) 320-3204

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14897
TX

Other

Enumeration date
11/04/2013
Last updated
11/04/2013
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