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ALICIA ITO FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
4250 PLYMOUTH RD, ANN ARBOR, MI 48109-2700
(734) 764-6443
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
6301013380
MI
103TC0700X
Clinical Psychologist
Primary
6301013380
MI

Other

Enumeration date
11/14/2008
Last updated
11/14/2008
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