Individual
S VALENCIA TYRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPC
Contact information
Practice address
920 CAPITOL HEIGHTS BLVD, SUITE #B, CAPITOL HEIGHTS, MD 20743
(240) 505-8960
(240) 505-8960
Mailing address
920 CAPITOL HEIGHTS BLVD, SUITE #B, CAPITOL HEIGHTS, MD 20743
(240) 505-8960
(240) 505-8960
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
077348897
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
462409305
CIGNA, UHC, CAREFIRST, AETNA, MEDICAID
MD
Enumeration date
03/20/2018
Last updated
03/20/2018
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