Provider Demographics
NPI:1437527470
Name:LEGER, MICHELLE JILL (MA)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:JILL
Last Name:LEGER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 CHAPMAN AVE, APT. 3-302
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840
Mailing Address - Country:US
Mailing Address - Phone:714-980-2332
Mailing Address - Fax:
Practice Address - Street 1:711 E. BALL ROAD
Practice Address - Street 2:SUITE #201 PROVIDENCE COMMUNITY SERVICES
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805
Practice Address - Country:US
Practice Address - Phone:714-254-8473
Practice Address - Fax:714-254-8480
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health