Individual
DR. BRENDA J. INGRAM-WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1401 UNION STREET, READING, PA 19604
(610) 921-7585
(610) 929-6697
Mailing address
PO BOX 13736, READING, PA 19612-3736
(610) 921-7585
(610) 929-6697
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS006970L
PA
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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