Individual
COLLEEN ANN FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
85 LEXINGTON AVE, MALVERNE, NY 11565-2315
(516) 313-7656
Mailing address
85 LEXINGTON AVE, MALVERNE, NY 11565-2315
(516) 313-7656
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021200-1
NY
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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