Individual
MRS. SUSAN FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1834
NH
225X00000X
Occupational Therapist
OT1974
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08Y010145NH01
ANTHEM
NH
01
—
388405
MVP
NH
Enumeration date
02/28/2007
Last updated
03/04/2008
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