Individual provider · Type 1 NPI
Stacy Ford
Mental Health Counselor · San Rafael, CA
NPI number
1053759605
Active
Practice location
1 Saint Vincents Dr
San Rafael, CA 94903-1504
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1053759605
Stacy Ford's National Provider Identifier is 1053759605, issued on Jun 5, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Rafael, CA. The record was last updated on Jun 5, 2013.