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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