Provider Demographics
NPI:1467229096
Name:INGRAM, TAYLOR NYCHELE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NYCHELE
Last Name:INGRAM
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 1:732 THIMBLE SHOALS BLVD STE 702
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4256
Mailing Address - Country:US
Mailing Address - Phone:757-309-7027
Mailing Address - Fax:
Practice Address - Street 1:732 THIMBLE SHOALS BLVD STE 702
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4256
Practice Address - Country:US
Practice Address - Phone:757-309-7027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional