Desirae Marie Legg
Individual provider Active NPI Behavior Technician · Kalkaska, MI
NPI 1548071392 · NPPES record last updated Sep 23, 2025
Key facts
- NPI
- 1548071392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 103 W 3Rd St # 524
Kalkaska, MI 49646-5107 - Phone
- (517) 918-4567
- NPI assigned
- Jan 20, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
103 W 3Rd St # 524
Kalkaska, MI 49646-5107
Mailing address
3050 Crofton Dr
Dewitt, MI 48820-7769
Other providers in Kalkaska, MI
- Labrover
- Amanda Latham
- Carri Rene Latta
- Alicia Ann Layman
- Kathleen Marie Leahy
- Life'S Work Clinic, PLLC
- Andrew James Long
- Kathryn Karen Mancewicz
- Michelle Marsh
- Carolyn Goodrich Martin
All providers in Kalkaska, MI · Behavior Technician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.