Individual
MRS. STEPHANIE LEGAKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
2345 50TH ST, LUBBOCK, TX 79412-2565
(806) 780-8300
(806) 780-8383
Mailing address
2345 50TH STREET, LUBBOCK, TX 79412
(806) 780-8300
(806) 780-8383
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11068
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065363601
—
TX
01
—
1912049156
BCBS
TX
Enumeration date
04/14/2010
Last updated
04/14/2010
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