Individual
REBECCA ANN LEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1512 SUSSEX CT, SHAKOPEE, MN 55379-7041
(612) 743-5452
Mailing address
1512 SUSSEX CT, SHAKOPEE, MN 55379-7041
(612) 743-5452
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1041320-1-AFC
MN
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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