Ingram, Mica Jill
Ingram, Mica Jill is an individual health care provider with primary practice located at 400 W Ih 635 Fwy Ste 360 , Irving TX 75063-3764. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Ingram, Mica Jill can be contacted via phone (972) 402-8404.Contact Information
Primary practice address
400 W Ih 635 Fwy Ste 360
Irving TX 75063-3764
Phone: (972) 402-8404
Fax: (972) 695-8796
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | 147001032 | Illinois |
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | 51740 | Texas |
Profile Details
| NPI number | 1720274061 |
|---|---|
| LBN Legal business name | Ingram, Mica Jill |
| Credentials | AU.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2007 |
| Last updated | Jul 9th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720274061 | NPPES |
| Louisiana | MEDICAID | 211151001 |
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