Doctor Name: | DONALD ALAN FORD |
NPI Number: | 1477818953 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | MH12129 |
Business Practice Address: | 4300 Duhme Rd Madeira Beach, FL - 337082892 |
Business Phone Number: | 7273917001 |
Business Fax Number: | 7273913125 |
Mailing Address: | 4300 Duhme Rd, MADEIRA BEACH |
State: | FL |
Postal Code: | 337082892 |
Phone Number: | 7273917001 |
Fax Number: | 7273913125 |
NPI Enumeration Date: | 07/10/2012 |
NPI Last Update Date: | 11/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH12129 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |