Provider Demographics
NPI:1457754921
Name:FORD, LINDA (RD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 GRAFTON SHOP RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2502
Mailing Address - Country:US
Mailing Address - Phone:443-417-9876
Mailing Address - Fax:
Practice Address - Street 1:1700 GRAFTON SHOP RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2502
Practice Address - Country:US
Practice Address - Phone:443-417-9876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered