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BRENDA S FORD LPC

Professional >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1538410576

Individual Registrant:
 BRENDA S FORD LPC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
101 LENA DR  ROGERSVILLE, TN 37857-2951 US
Tel: 423-272-9239  Fax: 423-467-3644

Contact information for business:
1167 SPRATLIN PARK DR  GRAY, TN 37615-6205 US
Tel: 423-467-3600  Fax: 423-467-3644

Registration Information:
NPI: 1538410576
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional
TN4099

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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