Provider Demographics
NPI:1346414653
Name:FORD, VICKI L (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:L
Last Name:FORD
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 E BELL ST
Mailing Address - Street 2:STE 312
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3052
Mailing Address - Country:US
Mailing Address - Phone:615-848-9265
Mailing Address - Fax:615-895-2155
Practice Address - Street 1:503 E BELL ST
Practice Address - Street 2:STE 312
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3052
Practice Address - Country:US
Practice Address - Phone:615-848-9265
Practice Address - Fax:615-895-2155
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1505237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter