| NPI | 1992274237 |
|---|---|
| Former Name | KEANNE LEGGETT |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60996401) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA SC60697576) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2021-03-12 |