Provider Demographics
NPI:1396942025
Name:LEDFORD, ALAN (PHD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:LEDFORD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 503010
Mailing Address - Street 2:
Mailing Address - City:WHITE CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97503-0813
Mailing Address - Country:US
Mailing Address - Phone:541-234-4781
Mailing Address - Fax:510-868-2924
Practice Address - Street 1:312 OAK ST STE 205
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2542
Practice Address - Country:US
Practice Address - Phone:541-499-0344
Practice Address - Fax:510-868-2924
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18903103TC0700X
OR2144103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical