Doctor Name: | CHRISTINE FORD |
NPI Number: | 1770637795 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 596 |
Business Practice Address: | 127 E 123rd St Galliano, LA - 703544223 |
Business Phone Number: | 9856322175 |
Business Fax Number: | 9856328651 |
Mailing Address: | 180 Old La 1, LOCKPORT |
State: | LA |
Postal Code: | 70374 |
Phone Number: | 9856937983 |
Fax Number: | 9856328651 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 596 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |