Doctor Name: | MR. GREGORY TODD KURTH-FORD |
NPI Number: | 1093874927 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, CAS |
License Number: | LC1042 |
Business Practice Address: | 1645 Liberty Rd Suite 104 Eldersburg, MD - 217846521 |
Business Phone Number: | 4104049058 |
Business Fax Number: | |
Mailing Address: | 73 Smith Ave, WESTMINSTER |
State: | MD |
Postal Code: | 211575744 |
Phone Number: | 4104049058 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LC1042 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |