Individual
DR. THOMAS W FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
501 MIZE STREET, LA FAYETTE, GA 30728-1027
(706) 638-5584
(706) 638-5585
Mailing address
PO BOX 1027, LA FAYETTE, GA 30728-1027
(706) 638-5584
(706) 638-5585
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY002405
GA
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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