Individual
JASON FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1830 S ALMA SCHOOL RD, MESA, AZ 85210-3056
(480) 730-6222
Mailing address
4248 S RED ROCK ST, GILBERT, AZ 85297-4501
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-21166
AZ
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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