Provider Information for 1871525956
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HOLLY DECANN INGRAM LPC
Sex: Female
NPI: 1871525956
Last Updated: 2021-08-10
Certification Date: 2021-08-10
Certification Date: 2021-08-10
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1871525956 | ||||||||||||||||||||
| Enumeration Date | 2006-07-07 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 445 DOLLEY MADISON RD STE 410 GREENSBORO, NC 27410-5167 United States Phone: 336-292-1510 | Fax:336-292-0679 | ||||||||||||||||||||
| Primary Practice Address | 445 DOLLEY MADISON RD STE 410 GREENSBORO, NC 27410-5167 United States Phone: 336-292-1510 | Fax:336-292-0679 | ||||||||||||||||||||
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