Provider Demographics
NPI:1134865603
Name:FORD, SKYLER (OTR/L)
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 PALMER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-5103
Mailing Address - Country:US
Mailing Address - Phone:508-540-5559
Mailing Address - Fax:508-540-5660
Practice Address - Street 1:620 PALMER AVE STE 2
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-5103
Practice Address - Country:US
Practice Address - Phone:508-540-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14449225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist