Provider Demographics
NPI:1508986803
Name:LEGGE, KRISTIN MARGARET (MHPP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MARGARET
Last Name:LEGGE
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 4 BOX 138AB
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-9305
Mailing Address - Country:US
Mailing Address - Phone:870-234-6995
Mailing Address - Fax:
Practice Address - Street 1:1269 CALIFORNIA SW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71730
Practice Address - Country:US
Practice Address - Phone:870-836-6468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARNONEOtherMENTAL HEALTH PARAPROFESS