Provider Demographics
NPI:1346048089
Name:LEGUE, ANNA M (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:LEGUE
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17932 SHOREHAM LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-4850
Mailing Address - Country:US
Mailing Address - Phone:614-306-0794
Mailing Address - Fax:
Practice Address - Street 1:17932 SHOREHAM LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-4850
Practice Address - Country:US
Practice Address - Phone:614-306-0794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26775225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist