Individual
MARY QUATTROCCHI LEGINO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4917 UNDERWOOD AVE, OMAHA, NE 68132-2421
(402) 556-1516
Mailing address
4917 UNDERWOOD AVE, OMAHA, NE 68132-2421
(402) 556-1516
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
NE191
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8152
BLUE CROSS PROVIDER NUMBE
NE
01
—
NE191
STATE LICENSE NUMBER
NE
Enumeration date
01/15/2006
Last updated
07/08/2007
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