Individual
ANGELA M INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LCPC
Contact information
Practice address
1752 AMBROSE TERRACE DR, SWANSEA, IL 62226-7376
(618) 920-5128
Mailing address
1752 AMBROSE TERRACE DR, SWANSEA, IL 62226-7376
(618) 920-5128
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.010041
IL
101YP2500X
Professional Counselor
180.010041
IL
Other
Enumeration date
12/21/2015
Last updated
11/14/2019
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