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Individual

JONATHAN DALE FORD I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
75 N 1ST ST, SCOTTSBURG, IN 47170-1637
(812) 752-2837
Mailing address
6623 DOVIR WOODS DR, SELLERSBURG, IN 47172-9151
(502) 810-4135

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IN

Other

Enumeration date
09/26/2022
Last updated
09/26/2022
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