Provider Demographics
NPI:1871837963
Name:FORD, DEANA ANN (MA)
Entity Type:Individual
Prefix:MS
First Name:DEANA
Middle Name:ANN
Last Name:FORD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73093-0073
Mailing Address - Country:US
Mailing Address - Phone:405-517-5541
Mailing Address - Fax:
Practice Address - Street 1:3926 S LADD AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:OK
Practice Address - Zip Code:73093-9243
Practice Address - Country:US
Practice Address - Phone:405-517-5541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health