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Individual

JANNA LEGG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSC, MSW

Contact information

Practice address
445 S 5TH ST W, MISSOULA, MT 59801-2619
(406) 545-0420
Mailing address
13053 KIMWOOD DR, LOLO, MT 59847-9520
(406) 545-0420

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-SWLC-LIC-51515
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
11/08/2022
Last updated
11/08/2022
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