Doctor Name: | MS. JENEANE R. FORD |
NPI Number: | 1811184823 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED |
License Number: | |
Business Practice Address: | 140 Forest Grove Ave Wrentham, MA - 020931097 |
Business Phone Number: | 5088162079 |
Business Fax Number: | |
Mailing Address: | Po Box 124, WRENTHAM |
State: | MA |
Postal Code: | 020930124 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/03/2007 |
NPI Last Update Date: | 10/03/2007 |
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: |