Individual
HEATHER FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
523 DIXIE ST, CARROLLTON, GA 30117-3870
(770) 456-3266
Mailing address
120 FRANCES PL, CARROLLTON, GA 30117-4332
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
85921
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/30/2011
Last updated
07/08/2020
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