| Legacy Therapeutic Interventions, Pllc | |
|
5403 Nessee St Fayetteville NC 28314-4600 | |
| (678) 674-9965 | |
| Not Available |
| Full Name | Legacy Therapeutic Interventions, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5403 Nessee St, Fayetteville, North Carolina |
| Authorized Official Name and Position | Yazlyn Maria Jacobs (CEO) |
| Authorized Official Contact | 6786749965 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Therapeutic Interventions, Pllc 5403 Nessee St Fayetteville NC 28314-4600 Ph: (678) 674-9965 | Legacy Therapeutic Interventions, Pllc 5403 Nessee St Fayetteville NC 28314-4600 Ph: (678) 674-9965 |
| NPI Number | 1689392177 |
|---|---|
| Provider Enumeration Date | 08/19/2022 |
| Last Update Date | 08/19/2022 |
| Certification Date | 08/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689392177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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