Provider Demographics
NPI:1609584473
Name:FORD, AZIYAH ARMAUNI
Entity Type:Individual
Prefix:
First Name:AZIYAH
Middle Name:ARMAUNI
Last Name:FORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 HERLONG AVE S
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1186
Mailing Address - Country:US
Mailing Address - Phone:803-323-6839
Mailing Address - Fax:
Practice Address - Street 1:199 HERLONG AVE S
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1186
Practice Address - Country:US
Practice Address - Phone:803-323-6839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)