Provider Demographics
NPI:1295985471
Name:FORD, PARIS S (OT)
Entity type:Individual
Prefix:MRS
First Name:PARIS
Middle Name:S
Last Name:FORD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CORPORATE CENTER CT STE B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-3839
Mailing Address - Country:US
Mailing Address - Phone:336-967-1649
Mailing Address - Fax:336-276-1728
Practice Address - Street 1:7 CORPORATE CENTER CT STE B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-3839
Practice Address - Country:US
Practice Address - Phone:336-967-1649
Practice Address - Fax:336-276-1728
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NC7747225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1548836406Medicaid
NC1862KOtherBCBS OF NC