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NPI Code Detail

MEDICARE: CASSANDRA FORD

MEDICARE: CASSANDRA 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
1224Z00000XOccupational Therapy AssistantTA2457MS

General Provider Information

NPI Number : 1033411442
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA FORD
Provider Business Mailing Address
First Line : 4109 HIGHWAY 98 W
Second Line :
City : SUMMIT
State : MS
Zip : 39666-9132
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 217 METHODIST BLVD
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-1338
Country : US
Telephone Number : 601-329-2233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2010
Last Update Date : 11/18/2010

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Directions to “ CASSANDRA FORD ” Practice Location

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