Provider Demographics
NPI:1447984406
Name:INGRAM, DEBORAH (NBC-HWC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:INGRAM
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 38TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-1632
Mailing Address - Country:US
Mailing Address - Phone:352-454-5915
Mailing Address - Fax:
Practice Address - Street 1:6774 102ND AVE N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-2909
Practice Address - Country:US
Practice Address - Phone:727-735-8722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach