Individual
MS. FANISHA R FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
436 OVERTON AVE, MARKSVILLE, LA 71351-2742
(318) 623-7331
Mailing address
436 OVERTON AVE, MARKSVILLE, LA 71351-2742
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z12052
LA
Other
Enumeration date
02/16/2009
Last updated
02/16/2009
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