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NPI Code Detail

MEDICARE: MAYA INGRAM

MEDICARE: MAYA INGRAM
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1245066844
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA INGRAM
Provider Business Mailing Address
First Line : 350 CROSS ST
Second Line :
City : MALDEN
State : MA
Zip : 02148-7917
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 350 CROSS ST
Second Line :
City : MALDEN
State : MA
Zip : 02148-7917
Country : US
Telephone Number : 508-556-4748
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2024
Last Update Date : 09/10/2024

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Directions to “ MAYA INGRAM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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