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Individual

CHARLOTTE G INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHP

Contact information

Practice address
2622 AVENUE C, SCOTTSBLUFF, NE 69361-1680
(308) 632-8547
(308) 632-0135
Mailing address
2622 AVENUE C, SCOTTSBLUFF, NE 69361-1680
(308) 632-8547
(308) 632-0135

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
438
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
232820
MIDLANDS CHOICE
NE
05
47083791626
NE
01
84839
BLUE CROSS/BLUE SHIELD
NE
Enumeration date
10/20/2006
Last updated
07/08/2007
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