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Individual

MISS KARLETTE RAESHAUN FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
2314 S VAL VISTA DR STE 201, GILBERT, AZ 85295-5594
(623) 263-3966
Mailing address
8705 E KIVA AVE, MESA, AZ 85209-5311
(708) 271-7880

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.002017
IL
225X00000X
Occupational Therapist
Primary
OTH-009793
AZ

Other

Enumeration date
07/06/2012
Last updated
11/08/2024
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