Doctor Name: | MRS. DENISE O. LEGG |
NPI Number: | 1003240169 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHP |
License Number: | 4474 |
Business Practice Address: | 11414 W Center Rd Suite 233 Omaha, NE - 681444486 |
Business Phone Number: | 4029606861 |
Business Fax Number: | |
Mailing Address: | 11611 Burt St, V4 OMAHA |
State: | NE |
Postal Code: | 681541595 |
Phone Number: | 4029606861 |
Fax Number: | |
NPI Enumeration Date: | 08/26/2013 |
NPI Last Update Date: | 05/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 4474 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |