| Doctor Name: | TAWNA MARIE LEDESMA |
| NPI Number: | 1538269477 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MED, LPC |
| License Number: | 2001018980 |
| Business Practice Address: | 1600 Heritage Landing Suite 116 St. Peters, MO - 63303 |
| Business Phone Number: | 6363451400 |
| Business Fax Number: | 6364413262 |
| Mailing Address: | 1600 Heritage Landing, Suite 116 ST. PETERS |
| State: | MO |
| Postal Code: | 63303 |
| Phone Number: | 6363451400 |
| Fax Number: | 6364413262 |
| NPI Enumeration Date: | 09/22/2006 |
| NPI Last Update Date: | 03/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2001018980 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |