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General NPI Number Information
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NPI Number | 1306280888
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Entity Type | Individual
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Provider Name | PENNIE LEGGETT M.A., L.A.M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 12033 AGENCY RD 730
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City | PARKER
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State | AZ
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Zip | 85344-7718
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Country | US
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Telephone | 928-669-3256
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Fax | 928-669-3252
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Provider Business Mailing Address
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Address Line | 12302 KENNEDY DR
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City | PARKER
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State | AZ
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Zip | 85344-9734
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Country | US
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Telephone | 928-669-3256
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Fax | 928-669-3252
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LAMFT-10311
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License Number State | AZ
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