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DR. THOMAS W FORD PH.D.
Counseling >> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1457417792
Individual Registrant:DR. THOMAS W FORD PH.D.
Gender: M
Not Sole Proprietor
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
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
Tel: 706-638-5584 Fax: 706-638-5585
Registration Information:
NPI: 1457417792
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103TC1900X | Behavioral Health & Social Service Providers Psychologist Counseling | GA | PSY002405 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
