Provider Demographics
NPI:1619749256
Name:FORD, DALEIGHA MARIE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:DALEIGHA
Middle Name:MARIE
Last Name:FORD
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:YUTAN
Mailing Address - State:NE
Mailing Address - Zip Code:68073-3009
Mailing Address - Country:US
Mailing Address - Phone:402-690-6097
Mailing Address - Fax:
Practice Address - Street 1:20800 W MAPLE RD # NE68022
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-5108
Practice Address - Country:US
Practice Address - Phone:402-566-5067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1005235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist