Provider Demographics
NPI:1144601790
Name:LAMOUR, INGRID ROSE
Entity Type:Individual
Prefix:MS
First Name:INGRID
Middle Name:ROSE
Last Name:LAMOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 ADAM CLAYTON BLVD
Mailing Address - Street 2:7A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027
Mailing Address - Country:US
Mailing Address - Phone:718-772-0200
Mailing Address - Fax:212-491-9563
Practice Address - Street 1:2090 ADAM CLAYTON BLVD
Practice Address - Street 2:7A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027
Practice Address - Country:US
Practice Address - Phone:718-772-0200
Practice Address - Fax:212-491-9563
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health