Individual
MRS. LAVONNE LESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4508 STADIUM BLVD, JONESBORO, AR 72404-9675
(870) 933-6886
(870) 933-9395
Mailing address
4508 STADIUM BLVD, JONESBORO, AR 72404-9675
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5T102
BLUECROSS PROVIDER NUMBER
AR
Enumeration date
07/04/2006
Last updated
07/08/2007
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