Doctor Name: | JERRY D LEGGETT |
NPI Number: | 1407150246 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M,DIV |
License Number: | |
Business Practice Address: | 81-6587 Mamalahoa Hwy Bldg C Kealakekua, HI - 96750 |
Business Phone Number: | 8083232664 |
Business Fax Number: | 8083232999 |
Mailing Address: | 91-1841 Fort Weaver Rd, EWA BEACH |
State: | HI |
Postal Code: | 967061909 |
Phone Number: | 8086813500 |
Fax Number: | 8086811486 |
NPI Enumeration Date: | 01/10/2011 |
NPI Last Update Date: | 01/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |