Healthcare Provider Details

I. General information

NPI: 1568848836
Provider Name (Legal Business Name): LEANORA LEGRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HILLIARD ROAD
KENSINGTON NH
03833
US

IV. Provider business mailing address

10 HILLIARD RD
KENSINGTON NH
03833-5515
US

V. Phone/Fax

Practice location:
  • Phone: 603-553-9728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: