| NPI | 1174396980 |
|---|---|
| Doing Business As | LEGACY ONLINE COUNSELING AND CONSULTING LLC |
| Entity Type | Organization |
| Authorized Contact | TONYA GRISSOM-TATROE CEO 870-919-6585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |