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Individual

LESLIE W FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
420A W WALNUT ST, DANVILLE, KY 40422-1836
(859) 936-9474
Mailing address
195 HERRINGTON WOODS, HARRODSBURG, KY 40330-9796
(859) 748-5613

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
600
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30615058
KY
Enumeration date
01/09/2007
Last updated
03/03/2015
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