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General NPI Number Information
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NPI Number | 1326469321
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Entity Type | Individual
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Provider Name | INDIA LEDBETTER
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Gender | Female
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Dates
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Enumeration Date | 12/18/2013
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Last Update Date | 02/12/2015
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Provider Practice Location Address
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Address Line | 620 S LAUREL ST
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City | PINE BLUFF
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State | AR
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Zip | 71601-4859
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Country | US
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Telephone | 870-534-4900
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Fax | 870-534-4906
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Provider Business Mailing Address
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Address Line | 620 S LAUREL ST
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City | PINE BLUFF
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State | AR
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Zip | 71601-4859
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Country | US
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Telephone | 870-534-4900
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Fax | 870-534-4906
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A1412169
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License Number State | AR
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