Individual
LESLEY SELF FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
201 N CLIFTON ST, FORDYCE, AR 71742-3026
(870) 352-6311
(870) 352-0223
Mailing address
PO BOX 115, IVAN, AR 71748-0115
(501) 837-5773
(870) 352-0223
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A1808119
AR
Other
Enumeration date
03/06/2007
Last updated
01/26/2024
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