Individual
MRS. AMANDA ROSE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
210 NORTH JT STITES BLVD, SALLISAW, OK 74955-9301
(918) 775-7787
Mailing address
210 NORTH JT STITES BLVD, SALLISAW, OK 74955-9301
(918) 775-7787
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/31/2024
Last updated
12/31/2024
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