Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 001468 | CT |
NPI | 1083638340 |
---|---|
Provider Name | Dr. Ralph R. Ford JR. |
First Address | Bridgeport, CT 06604-4219 |
Second Address | Bridgeport, CT 06604-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |