| Doctor Name: | MRS. AMY D. FORD |
| NPI Number: | 1205871613 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LSCSW |
| License Number: | 348 |
| Business Practice Address: | 1601 W 4th St Coffeyville, KS - 673373333 |
| Business Phone Number: | 6202528180 |
| Business Fax Number: | 6203321940 |
| Mailing Address: | Po Box 688, INDEPENDENCE |
| State: | KS |
| Postal Code: | 673010688 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/19/2006 |
| NPI Last Update Date: | 03/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 348 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |