Individual
MRS. KATIE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT,LPC
Contact information
Practice address
2500 NE TWIN KNOLLS DR STE 260, BEND, OR 97701-4786
(661) 426-4213
(661) 852-2777
Mailing address
73 SW TAFT AVE, BEND, OR 97702-1286
(661) 426-4213
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
C2149
OR
106H00000X
Marriage & Family Therapist
Primary
MFC35625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500737088
—
OR
Enumeration date
07/11/2007
Last updated
09/09/2024
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