Individual
MARCIALEE LEDBETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
25 JUNE ST, SANFORD, ME 04073-2621
(207) 324-4310
Mailing address
5148 N ASHLAND AVE # 1, CHICAGO, IL 60640-2830
(918) 995-0584
(918) 660-3631
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20207
OK
2084P0804X
Child & Adolescent Psychiatry Physician
036084346
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10023880D
—
OK
Enumeration date
01/26/2006
Last updated
10/24/2022
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