Individual
LISA ANNE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2118 INWOOD DR, SUITE 102, FORT WAYNE, IN 46815-7101
(260) 483-9081
(260) 483-9196
Mailing address
2118 INWOOD DR, SUITE 102, FORT WAYNE, IN 46815-7101
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004887A
IN
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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