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General NPI Number Information
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NPI Number | 1407994759
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Entity Type | Individual
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Provider Name | MRS. LILLIE CARTER-FORD
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Gender | Female
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 3333 W 20TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32254-1703
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Country | US
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Telephone | 904-945-3511
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Fax | 904-493-4468
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Provider Business Mailing Address
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Address Line | 988 ASHTON COVE TER
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City | JACKSONVILLE
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State | FL
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Zip | 32218-6126
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Country | US
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Telephone | 904-612-4791
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Fax | 904-641-6529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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