| Doctor Name: | HEIDI INGRAM |
| NPI Number: | 1356775407 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CFY-SLP |
| License Number: | 108960 |
| Business Practice Address: | 10450 Brian Mooney Ave El Paso, TX - 799352809 |
| Business Phone Number: | 9155986616 |
| Business Fax Number: | 9155986651 |
| Mailing Address: | 12227 Henri Matisse Ave, EL PASO |
| State: | TX |
| Postal Code: | 799360230 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/26/2013 |
| NPI Last Update Date: | 08/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 108960 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |