Provider Demographics
NPI:1679281117
Name:LEDFORD, TARA JEAN
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:JEAN
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TARA
Other - Middle Name:JEAN
Other - Last Name:PLANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13500 CHENAL PKWY APT 1003
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-5348
Mailing Address - Country:US
Mailing Address - Phone:501-288-8791
Mailing Address - Fax:
Practice Address - Street 1:9701 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2123
Practice Address - Country:US
Practice Address - Phone:501-424-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator