Provider Demographics
NPI:1083673099
Name:LEGGETT, MELANIE KRISTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:KRISTIN
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:508 FULTON ST
Mailing Address - Street 2:VAMC PSYCHOLOGY SERVICE 116B
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3875
Mailing Address - Country:US
Mailing Address - Phone:919-286-0411
Mailing Address - Fax:919-416-5832
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:VAMC PSYCHOLOGY SERVICE 116B
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:919-416-5832
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2921103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical