Individual
MRS. ALEXANDRIA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, R-DMT
Contact information
Practice address
2801 BERTHOLET BLVD STE 301, VALPARAISO, IN 46383-7959
(219) 323-3311
Mailing address
14563 S 450 W, HANNA, IN 46340-9704
(219) 246-0354
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300001910
—
IN
Enumeration date
10/17/2022
Last updated
10/17/2022
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