Provider Demographics
NPI:1366714842
Name:INGALA, ANN MARIE
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:INGALA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 POPE AVENUE
Mailing Address - Street 2:MUNSON ARMY HEALTH CENTER
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-2332
Mailing Address - Country:US
Mailing Address - Phone:913-684-6562
Mailing Address - Fax:
Practice Address - Street 1:550 POPE AVENUE
Practice Address - Street 2:MUNSON ARMY HEALTH CENTER
Practice Address - City:FORT LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66027-2332
Practice Address - Country:US
Practice Address - Phone:913-684-6562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling