Individual
TYRA LAVIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
822 WOODWAY ST, BOWLING GREEN, KY 42101-2771
(270) 901-5000
Mailing address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
KY
Other
Enumeration date
04/07/2026
Last updated
04/07/2026
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