Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 4474 | NE |
Y | 101YP2500X | Professional Counselor | 1377 | NE |
N | 101YP2500X | Professional Counselor | 2178 | NE |
NPI | 1003240169 |
---|---|
Provider Name | Mrs. Denise O. Legg |
First Address | Omaha, NE 68144-4486 |
Second Address | Omaha, NE 68144-4486 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2013 |
Last Update Date | 30/11/2016 |