Doctor Name: | MS. KASEY R FORD |
NPI Number: | 1457539173 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 130 W 7th St Mount Carmel, IL - 628631439 |
Business Phone Number: | 6182633873 |
Business Fax Number: | 6182633893 |
Mailing Address: | 130 W 7th St, MOUNT CARMEL |
State: | IL |
Postal Code: | 628631439 |
Phone Number: | 6182633873 |
Fax Number: | 6182633893 |
NPI Enumeration Date: | 02/05/2008 |
NPI Last Update Date: | 02/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |