Individual
MACKENZIE RUTH FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDCD
Contact information
Practice address
10703 RANCH ROAD 12, WIMBERLEY, TX 78676-5239
(512) 955-5510
Mailing address
10703 RANCH ROAD 12, WIMBERLEY, TX 78676-5239
(512) 955-5510
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14425
TX
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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