Leslie Nicole Ferguson

Individual provider Active NPI Developmental Therapist · Flatgap, KY

NPI 1124536719 · NPPES record last updated Jan 17, 2018

Key facts

NPI
1124536719
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
881 Ky Route 689 E
Flatgap, KY 41219-9546
Phone
(606) 265-8891
Fax
(606) 265-4409
NPI assigned
Jan 17, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

881 Ky Route 689 E
Flatgap, KY 41219-9546

Mailing address

881 Ky Route 689 E
Flatgap, KY 41219-9546
Phone (606) 265-8891

Other providers in Flatgap, KY

All providers in Flatgap, KY · Developmental Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.