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NPI Code Detail

MEDICARE: MRS. YETTA INGRAM-CANTY MHC

MEDICARE:  MRS. YETTA  INGRAM-CANTY  MHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1134379266
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. YETTA INGRAM-CANTY MHC
Provider Business Mailing Address
First Line : 2088 SHELBY ST
Second Line :
City : COLUMBUS
State : GA
Zip : 31903-3010
Country : US
Telephone Number : 706-256-3212
Fax Number : 706-256-0124
Provider Business Practice Location Address
First Line : 2088 SHELBY ST
Second Line :
City : COLUMBUS
State : GA
Zip : 31903-3010
Country : US
Telephone Number : 706-256-3212
Fax Number : 706-256-0124
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2008
Last Update Date : 09/25/2008

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Directions to “ MRS. YETTA INGRAM-CANTY MHC” Practice Location

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