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3228 Brainerd Rd Chattanooga TN 37411-3500 | |
| (423) 370-3010 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3228 Brainerd Rd, Chattanooga, Tennessee |
| Authorized Official Name and Position | Pennie Leggett (DIRECTOR/CLINICIAN) |
| Authorized Official Contact | 9289167065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
107 Elmwood Dr Chattanooga TN 37411-4209 Ph: (928) 916-7065 | 3228 Brainerd Rd Chattanooga TN 37411-3500 Ph: (423) 370-3010 |
| NPI Number | 1841936366 |
|---|---|
| Provider Enumeration Date | 05/08/2022 |
| Last Update Date | 08/29/2024 |
| Certification Date | 08/29/2024 |
| Medicare PECOS PAC ID | 0244765873 |
|---|---|
| Medicare Enrollment ID | O20241120000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841936366 | NPI | - | NPPES |
| Provider Name | Pennie Leggett |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306280888 PECOS PAC ID: 1153856786 Enrollment ID: I20241120000226 |
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