Individual
BRIAN LEGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 RIVER RD STE 106, EDGEWATER, NJ 07020-1002
(201) 606-2592
Mailing address
125 RIVER RD STE 106, EDGEWATER, NJ 07020-1002
(201) 606-2592
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
017910
PA
103T00000X
Psychologist
Primary
35SI00557600
NJ
Other
Enumeration date
10/27/2015
Last updated
12/03/2024
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