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Individual

DR. GRACE SUSIE FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D

Contact information

Practice address
2424 DOUBLE CHURCHES RD, COLUMBUS, GA 31909-2741
(706) 326-3301
(706) 327-7592
Mailing address
2424 DOUBLE CHURCHES RD, COLUMBUS, GA 31909-2741
(706) 326-3301
(706) 327-7592

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP000323
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
344464474A
GA
01
52265958
BLUE CROSS BLUE SHIELD #
GA
Enumeration date
03/23/2007
Last updated
12/08/2010
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