Individual
COURTNEY FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5900 PORTAGE RD, PORTAGE, MI 49002-1774
(269) 806-9679
(269) 344-2809
Mailing address
5900 PORTAGE RD, PORTAGE, MI 49002-1774
(269) 806-9679
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015673
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301015673
LICENSE #
MI
Enumeration date
08/18/2016
Last updated
06/19/2023
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