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Individual

MR. MARTIN P. FORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC II

Contact information

Practice address
162 SYLVAN ST, MELROSE, MA 02176-5415
(781) 662-5345
Mailing address
162 SYLVAN ST, MELROSE, MA 02176-5415
(781) 662-5345

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2429
MA

Other

Enumeration date
02/01/2012
Last updated
02/01/2012
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