Lisa Ingrum

NPI #1457472375 in Charleston, Illinois

Provider Information

NPI Number: 1457472375
Entity Type: Individual
Name: Lisa Ingrum
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Developmental Therapist
Enumeration Date: Apr 2, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1530 LINCOLN AVE
City: Charleston
State: Illinois
ZIP Code: 61920-3057
Phone: (217) 348-0127

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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