Provider Demographics
NPI:1235227273
Name:FORD, KENDRA JANELL (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:JANELL
Last Name:FORD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 TAGGERD RD
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-8186
Mailing Address - Country:US
Mailing Address - Phone:580-653-2278
Mailing Address - Fax:
Practice Address - Street 1:301 W MAIN ST STE 324
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6322
Practice Address - Country:US
Practice Address - Phone:580-226-9222
Practice Address - Fax:580-226-9226
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK857106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist