Individual
VANESA FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
11472 NW FORD FARM TRL, BRISTOL, FL 32321-3718
(850) 643-2949
Mailing address
11472 NW FORD FARM TRL, BRISTOL, FL 32321-3718
(850) 570-8065
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609182658
—
FL
Enumeration date
08/27/2010
Last updated
09/10/2019
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