Doctor Name: | JANN LEDBETTER |
NPI Number: | 1063818128 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M. ED., LPC |
License Number: | |
Business Practice Address: | 1101 E Washington Ave Mcalester, OK - 745014919 |
Business Phone Number: | 9184205006 |
Business Fax Number: | 9184205087 |
Mailing Address: | 1101 E Washington Ave, MCALESTER |
State: | OK |
Postal Code: | 745014919 |
Phone Number: | 9184205006 |
Fax Number: | 9184205087 |
NPI Enumeration Date: | 11/17/2014 |
NPI Last Update Date: | 11/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |