Individual provider · Type 1 NPI
Mallory Ford
Counselor · Russellville, AR
NPI number
1699295311
Active
Practice location
1610 S Arkansas Ave
Russellville, AR 72801-7125
Fax (479) 967-7140
Mailing address
602 N Walton Blvd
Bentonville, AR 72712-4576
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor Primary | 101Y00000X | None listed |
Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
2 other providers at this address
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About NPI 1699295311
Mallory Ford's National Provider Identifier is 1699295311, issued on Jun 23, 2017. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Russellville, AR. The record was last updated on Jun 23, 2017.