Provider Demographics
NPI:1912161142
Name:NEWINGHAM, GINGER ANN (GINGER NEWINGHAM)
Entity type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:ANN
Last Name:NEWINGHAM
Suffix:
Gender:F
Credentials:GINGER NEWINGHAM
Other - Prefix:MISS
Other - First Name:GINGER
Other - Middle Name:ANN
Other - Last Name:MALCOLM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 W CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:CARLINVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62626-1635
Mailing Address - Country:US
Mailing Address - Phone:217-854-2562
Mailing Address - Fax:
Practice Address - Street 1:707 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:CARLINVILLE
Practice Address - State:IL
Practice Address - Zip Code:62626-1635
Practice Address - Country:US
Practice Address - Phone:217-854-2562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist