| Pordford, Inc. | |
|
5200 Willson Rd Suite 309 Edina MN 55424-1332 | |
| (952) 927-8528 | |
| (612) 929-2327 |
| Full Name | Pordford, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 5200 Willson Rd, Edina, Minnesota |
| Authorized Official Name and Position | Debbra A Ford (PSYCHOLOGIST) |
| Authorized Official Contact | 9529278528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pordford, Inc. 5200 Willson Rd Suite 309 Edina MN 55424-1332 Ph: (952) 927-8528 | Pordford, Inc. 5200 Willson Rd Suite 309 Edina MN 55424-1332 Ph: (952) 927-8528 |
| NPI Number | 1457530453 |
|---|---|
| Provider Enumeration Date | 10/26/2007 |
| Last Update Date | 11/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457530453 | NPI | - | NPPES |
| 2410281 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2846 (Minnesota) | Primary |
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