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Organization
LEGACY MENTAL HEALTH SERVICES PROFESSIONAL CORPORATION
Active
Organization
LEGACY MENTAL HEALTH SERVICES PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TYISHA RENEE FLETCHER PMHNP (OWNER)
(702) 605-7018
Entity
Organization
Contact information
Practice address
2850 W HORIZON RIDGE PKWY STE 200, HENDERSON, NV 89052-4395
(702) 605-7018
Mailing address
12267 HARVEST SKY WAY UNIT 3, LAS VEGAS, NV 89183-5974
(310) 251-6727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/03/2024
Last updated
12/09/2024
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