Provider Demographics
NPI:1629451646
Name:LEGER, JOHANNE M (LPPC)
Entity type:Individual
Prefix:
First Name:JOHANNE
Middle Name:M
Last Name:LEGER
Suffix:
Gender:F
Credentials:LPPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 MONROE ST NE APT 2
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1263
Mailing Address - Country:US
Mailing Address - Phone:505-401-7927
Mailing Address - Fax:
Practice Address - Street 1:4125 CARLISLE BLVD NE STE E
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4806
Practice Address - Country:US
Practice Address - Phone:505-401-7927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional