Provider Demographics
NPI:1689485286
Name:FORD, JOSHUA DEJUAN
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DEJUAN
Last Name:FORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 DAUPHIN ISLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36605-3004
Mailing Address - Country:US
Mailing Address - Phone:251-476-5733
Mailing Address - Fax:
Practice Address - Street 1:1924 DAUPHIN ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36605-3004
Practice Address - Country:US
Practice Address - Phone:251-476-5733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor