Individual
BRIANA MARIE INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 NY-111, SMITHTOWN, NY 11780
(631) 656-9550
Mailing address
27 WEST DR, KINGS PARK, NY 11754-3804
(631) 416-0442
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111670-01
NY
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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