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1568937795
JACKIE LEE FORD
SPOKANE, WA
NPI
1568937795
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-10-03
Last Update Date
2018-10-03
Business Address
JACKIE LEE FORD CDP
4324 N JEFFERSON ST
SPOKANE, WA 99205-1209
Phone number: 509-315-8682
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Mailing Address
JACKIE LEE FORD CDP
4324 N JEFFERSON ST
SPOKANE, WA 99205-1209
Phone number: 509-315-8682
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