Individual
JEANNIE LEGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
601 SMALL COUNTRY LN, MIDLAND, NC 28107-7239
(704) 771-0051
Mailing address
601 SMALL COUNTRY LN, MIDLAND, NC 28107-7239
(704) 771-0051
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6187
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6187
STATE OF NC
NC
Enumeration date
03/30/2018
Last updated
03/30/2018
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