Healthcare Provider Details

I. General information

NPI: 1538080478
Provider Name (Legal Business Name): CAROLINE INGLE LGPAT, ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARO INGLE LGPAT, ATR-P

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 GORSUCH AVE
BALTIMORE MD
21218-3602
US

IV. Provider business mailing address

949 GORSUCH AVE
BALTIMORE MD
21218-3602
US

V. Phone/Fax

Practice location:
  • Phone: 410-467-4121
  • Fax: 410-267-6709
Mailing address:
  • Phone: 410-467-4121
  • Fax: 410-267-6709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberATG415
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: