Individual
MATTHEW TYRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
33 VARDEN DR, AIKEN, SC 29803-5285
(803) 642-3980
Mailing address
33 VARDEN DR, AIKEN, SC 29803-5285
(803) 642-3980
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7878
SC
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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