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Individual

STACEY R FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
10100 E ADOBE RD, MESA, AZ 85207-5404
(480) 529-6355
Mailing address
1930 E SOUTHERN AVE, TEMPE, AZ 85282-7518
(480) 456-0719

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP6245
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
442037
AZ
Enumeration date
07/17/2009
Last updated
06/04/2025
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