Individual
MS. MYRA J. FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA PPC PAT
Contact information
Practice address
420 DEANNE AVE, NEWCASTLE, WY 82701-2936
(307) 746-4456
(307) 746-4470
Mailing address
420 DEANNE AVE, NEWCASTLE, WY 82701-2936
(307) 746-4456
(307) 746-4470
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAT-299
WY
101YP2500X
Professional Counselor
PAT 016
WY
101YP2500X
Professional Counselor
PPC-221
WY
Other
Enumeration date
12/14/2006
Last updated
12/17/2015
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