Provider Demographics
NPI:1184271181
Name:INGRAM SAULS, AMY (MA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:INGRAM SAULS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:INGRAM SAULS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-2177
Mailing Address - Country:US
Mailing Address - Phone:304-269-3923
Mailing Address - Fax:304-269-9733
Practice Address - Street 1:5 BROWN AVE
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-2177
Practice Address - Country:US
Practice Address - Phone:304-269-3923
Practice Address - Fax:304-269-9733
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1236103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling