Individual
MARY MAYHEW INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1518 WALNUT ST # 19102, SUITE 804, PHILADELPHIA, PA 19102-3419
(215) 867-9358
Mailing address
214 PRICE AVE, APT C 32, NARBERTH, PA 19072-1843
(215) 867-9358
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF000911
PA
Other
Enumeration date
04/17/2016
Last updated
09/28/2016
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