Provider Demographics
NPI:1851139851
Name:FORD, MERILEE (MA, CHC)
Entity type:Individual
Prefix:
First Name:MERILEE
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:MA, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E CRANBERRY HILL DR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9487
Mailing Address - Country:US
Mailing Address - Phone:801-512-1196
Mailing Address - Fax:
Practice Address - Street 1:102 E CRANBERRY HILL DR
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9487
Practice Address - Country:US
Practice Address - Phone:801-512-1196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor