Provider Demographics
NPI:1205157310
Name:FORD, CATHERINE ANN (MS CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANN
Last Name:FORD
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 RTE 215
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-9438
Mailing Address - Country:US
Mailing Address - Phone:716-982-8770
Mailing Address - Fax:
Practice Address - Street 1:36 UNION ST.
Practice Address - Street 2:
Practice Address - City:DRYDEN
Practice Address - State:NY
Practice Address - Zip Code:13053-0088
Practice Address - Country:US
Practice Address - Phone:607-844-8694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021051235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist