Provider Demographics
NPI:1205156288
Name:FORD, DANIEL GEORGE (MSSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:GEORGE
Last Name:FORD
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S GARNETT RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74128-1805
Mailing Address - Country:US
Mailing Address - Phone:918-438-4257
Mailing Address - Fax:918-574-2813
Practice Address - Street 1:201 S GARNETT RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-1805
Practice Address - Country:US
Practice Address - Phone:918-438-4257
Practice Address - Fax:918-574-2813
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK00301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical