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Individual

MRS. JENNIFER CLAIRE LEGGOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYH

Contact information

Practice address
124 N MAIN ST STE C, BERLIN, MD 21811-1062
(410) 641-4598
(410) 641-4696
Mailing address
124 N MAIN ST STE C, BERLIN, MD 21811-1062
(410) 641-4598
(410) 543-2233

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
03814
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019077200
MD
Enumeration date
08/03/2006
Last updated
04/03/2012
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