Individual
MS. LESLIE ELAINE GALVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
111 MARBLE DR, JACKSONVILLE, AR 72076-4971
(501) 952-9466
Mailing address
111 MARBLE, 111 MARBLE DRIVE, JACKSONVILLE, AR 72076
(501) 952-9466
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1977-M
AR
1041C0700X
Clinical Social Worker
Primary
2425-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116399726
—
AR
Enumeration date
08/15/2007
Last updated
02/02/2024
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