Provider Demographics
NPI:1699146415
Name:FOARD, EMILY CATHERINE (BA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CATHERINE
Last Name:FOARD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-844-3541
Mailing Address - Fax:
Practice Address - Street 1:1411 N WEST SHORE BLVD STE 115
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4564
Practice Address - Country:US
Practice Address - Phone:813-844-3541
Practice Address - Fax:813-844-4283
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY12018103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist