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Individual
DR. JACK ROBERT LEGGETT JR.
Active
Individual
DR. JACK ROBERT LEGGETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PSY16148
CA
103TH0100X
Health Service Psychologist
—
—
Other
Enumeration date
09/10/2008
Last updated
09/10/2008
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