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Leslie Southall
Mental Health Counselor in Russellville, Arkansas
NPI 1205422094

Leslie Southall is a Mental Health Counselor based in Greenbrier, AR and is specialized in Mental Health. Leslie Southall practices in Russellville, AR. The NPI Number for Leslie Southall is 1205422094 and holds a License No. A2201001 (Arkansas).

The current practice location address for Leslie Southall is 1310 W Main St Ste 100, Russellville, AR and can be reached out via phone at 479-964-2011.

Location: 1310 W Main St Ste 100, Russellville, AR, 72058-9286
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205422094
Provider Name
Leslie Southall
Credential
Provider Entity Type
Individual
Gender
Male
Address
1310 W Main St Ste 100, Russellville, AR, 72058-9286
Phone Number
479-964-2011
Fax Number
Provider Enumeration Date
12/15/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1310 W Main St Ste 100
City
Russellville
State
Arkansas
Zip
72801-2803
Phone Number
479-964-2011
Fax Number
person
Provider Business Mailing Address Details
Address
1310 W Main St Ste 100
City
Russellville
State
Arkansas
Zip
72801-2803
Phone Number
479-964-2011
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
A2201001 (Arkansas)
Definition
Definition to come...
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