| Doctor Name: | DENNIS CHARLES LEGENDRE |
| NPI Number: | 1013201581 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW-S, LICDC |
| License Number: | 82790 |
| Business Practice Address: | 4100 W. Third Street Dayton Va Medical Center Dayton, OH - 45428 |
| Business Phone Number: | 5136732564 |
| Business Fax Number: | |
| Mailing Address: | 1 Rock Island, Imne-ria-hre, Asap/eap, Building 110, Se Wing 1st Floor ROCK ISLAND |
| State: | IL |
| Postal Code: | 61299 |
| Phone Number: | 3097822553 |
| Fax Number: | 3027820380 |
| NPI Enumeration Date: | 06/02/2011 |
| NPI Last Update Date: | 03/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 82790 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |