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General NPI Number Information
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NPI Number | 1912613134
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Entity Type | Organization
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Legal Business Name | BETH INGRAM & ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 4222 S FLORIDA AVE
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City | LAKELAND
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State | FL
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Zip | 33813-1628
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Country | US
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Telephone | 813-653-1149
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Fax |
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Provider Business Mailing Address
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Address Line | 602 VONDERBURG DR STE 201
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City | BRANDON
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State | FL
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Zip | 33511-5900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | VANESSA BANKS
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Credential |
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Telephone | 813-508-2991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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