Provider Demographics
NPI:1083426837
Name:FORD, JASMINE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:FORD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 COURT ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-1273
Mailing Address - Country:US
Mailing Address - Phone:860-613-9930
Mailing Address - Fax:860-613-9952
Practice Address - Street 1:528 WHEELERS FARMS RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-1847
Practice Address - Country:US
Practice Address - Phone:203-877-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist