Healthcare Provider Details

I. General information

NPI: 1750212676
Provider Name (Legal Business Name): TRUDY LEE LEGATT SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 MINNESOTA AVE
BIG LAKE MN
55309-8800
US

IV. Provider business mailing address

1495 RONNEBY RD NE
FOLEY MN
56329-9786
US

V. Phone/Fax

Practice location:
  • Phone: 763-262-7209
  • Fax:
Mailing address:
  • Phone: 320-249-5388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12053798
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: