Most Relevant Information
Provider Data
| NPI Number: | 1003694753 |
| Provider Name: | TEGAN JEAN LEGENDRE BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 1-23-67794 |
Most Important Dates
| Enumeration Date: | 09/14/2023 |
| Last Updated: | 09/14/2023 |
Provider Practice Location
3257 LOWER BURRIS RD
CANTON
GA
301144495
Practice Location Phone/Fax
| Phone: | 4703343324 |
| Fax: |
Provider Mailing Location
3257 LOWER BURRIS RD
CANTON
GA
301144495
Provider Mailing Phone/Fax
| Phone: | 4703343324 |
| Fax: |