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General NPI Number Information
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NPI Number | 1740539840
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Entity Type | Individual
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Provider Name | MARK FELTON LEGGETT PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 812 5TH AVENUE
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City | TUSCALOOSA
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State | AL
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Zip | 35401
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Country | US
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Telephone | 205-454-1365
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Fax |
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Provider Business Mailing Address
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Address Line | 1017 MAIN AVENUE
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City | NORTHPORT
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State | AL
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Zip | 35476
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Country | US
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Telephone | 205-454-1365
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1797
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License Number State | AL
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