Individual
ASHLEY NICHOLE FARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 N 3RD ST, LEESVILLE, LA 71446-4014
(337) 239-3334
(337) 239-3336
Mailing address
112 N 3RD ST, LEESVILLE, LA 71446-4014
(337) 239-3334
(337) 239-3336
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
23-279065
TX
106S00000X
Behavior Technician
Primary
R-26001
LA
Other
Enumeration date
10/11/2023
Last updated
04/06/2026
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