Provider Demographics
NPI:1063698355
Name:LEGER-DAVIE, NANCY LYNN (LCDC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LYNN
Last Name:LEGER-DAVIE
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 COUNTY ROAD 6052
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-7948
Mailing Address - Country:US
Mailing Address - Phone:936-258-2084
Mailing Address - Fax:
Practice Address - Street 1:37 COUNTY ROAD 6052
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TX
Practice Address - Zip Code:77535-7948
Practice Address - Country:US
Practice Address - Phone:936-258-2084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9855101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)