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1417049636
BETTY JEAN FORD
PROVO, UT
NPI
1417049636
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 4929004-3501)
Enumeration Date
2006-09-28
Last Update Date
2007-07-08
Business Address
-- BETTY JEAN FORD LCSW
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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Mailing Address
-- BETTY JEAN FORD LCSW
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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