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Individual

MR. MARK JAMES INGRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.P.C.

Contact information

Practice address
9421 E 95TH PL, TULSA, OK 74133-6166
(918) 557-8476
Mailing address
9421 E 95TH PL, TULSA, OK 74133-6166
(918) 557-8476

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1581
OK

Other

Enumeration date
06/02/2008
Last updated
06/02/2008
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