Mitchell-Ingram, Takeisha

Mitchell-Ingram, Takeisha is an sole proprietor health care provider with primary practice located at 130 S Indian River Dr Ste 202 , Fort Pierce FL 34950-4353. She recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as her primary health care specialty. Mitchell-Ingram, Takeisha can be contacted via phone (772) 905-9030.

Contact Information

Primary practice address
130 S Indian River Dr Ste 202 Fort Pierce FL 34950-4353
Phone: (772) 905-9030
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X

Profile Details

NPI number 1801312830
LBN Legal business name Mitchell-Ingram, Takeisha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2017
Last updated Aug 22nd, 2017 - 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.

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