Individual
KATIE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2827 NORTHGATE BLVD, FORT WAYNE, IN 46835-2900
(260) 492-1400
Mailing address
1317 LOUISEDALE DR, FORT WAYNE, IN 46808-1555
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002073A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32002073A
—
IN
Enumeration date
01/21/2014
Last updated
01/30/2024
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