Provider Demographics
NPI:1407138365
Name:LEDFORD, BRITTANY RYAN (BS)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:RYAN
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:RYAN
Other - Last Name:KIMBALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:435 CLARK RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-5596
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:435 CLARK RD
Practice Address - Street 2:SUITE 104
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-5596
Practice Address - Country:US
Practice Address - Phone:904-683-1425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health