Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | 2012921 | CA |
NPI | 1023533361 |
---|---|
Provider Name | Dr. John Nicholas Leggio |
First Address | Long Beach, CA 90813-3124 |
Second Address | Long Beach, CA 90813-3124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2017 |
Last Update Date | 21/02/2019 |