MEDICARE: KENDRA YVONNE FORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	34463	MD

General Provider Information

NPI Number	:	1033067665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA YVONNE FORD

Provider Business Mailing Address
First Line	:	830 COPLEY AVE
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-2801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	830 COPLEY AVE
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-2801
Country	:	US
Telephone Number	:	240-682-3157
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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Directions to “ KENDRA YVONNE FORD ” Practice Location

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