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General NPI Number Information
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NPI Number | 1447998232
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Entity Type | Individual
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Provider Name | KIAYRA INGRAM LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 16701 MELFORD BLVD STE 400
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City | BOWIE
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State | MD
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Zip | 20715-4411
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Country | US
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Telephone | 301-615-1911
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Fax |
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Provider Business Mailing Address
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Address Line | 4207 FURLEY AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-5734
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Country | US
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Telephone | 410-690-1509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 27876
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License Number State | MD
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