Organization · Type 2 NPI
Star Legacy Behavioral Health PLLC
Psychiatric/Mental Health Nurse Practitioner · Spokane, WA
NPI number
1104409010
Active
Practice location
100 N Howard St Ste R
Spokane, WA 99201-0508
Mailing address
3740 N Josey Ln Ste 213
Carrollton, TX 75007-2472
Other practice locations
- 3740 N Josey Ln Ste 213, Carrollton, TX 75007-2472 · (214) 810-5543
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1104409010
Star Legacy Behavioral Health PLLC's National Provider Identifier is 1104409010, issued on Apr 29, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Spokane, WA. The record was last updated on Sep 24, 2025.