Individual
MIKENZI FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
500 E 1400 N, LOGAN, UT 84341-8434
(435) 716-1000
Mailing address
PO BOX 567, MILLVILLE, UT 84326-0567
(435) 820-0055
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10836855-4102
UT
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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