Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC006821 | PA |
NPI | 1003157066 |
---|---|
Provider Name | Dorothy L Ingram |
First Address | Brownsville, PA 15417-8706 |
Second Address | Brownsville, PA 15417-8706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2013 |
Last Update Date | 14/03/2013 |