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DR. THOMAS W FORD PH.D.

Counseling >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1457417792

Individual Registrant:
DR. THOMAS W FORD PH.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
501 MIZE STREET  LA FAYETTE, GA 30728-1027 US
Tel: 706-638-5584  Fax: 706-638-5585

Contact information for business:
PO BOX 1027  LA FAYETTE, GA 30728-1027 US
Tel: 706-638-5584  Fax: 706-638-5585

Registration Information:
NPI: 1457417792
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TC1900XBehavioral Health & Social Service Providers
Psychologist
Counseling
GAPSY002405

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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