Provider Demographics
NPI:1184790180
Name:FORD, BARBARA A (OTR, CLT)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:FORD
Suffix:
Gender:F
Credentials:OTR, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2982 S RIVER BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:IN
Mailing Address - Zip Code:47243-8205
Mailing Address - Country:US
Mailing Address - Phone:812-599-3082
Mailing Address - Fax:
Practice Address - Street 1:2982 S RIVER BLUFF DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:IN
Practice Address - Zip Code:47243-8205
Practice Address - Country:US
Practice Address - Phone:812-599-3082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
IN31002348A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist