Individual
TYRONE TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 N CENTRAL AVE STE 200, PHOENIX, AZ 85004-1844
(602) 307-5330
Mailing address
1101 N CENTRAL AVE STE 200, PHOENIX, AZ 85004-1844
(602) 307-5330
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAC-18322
AZ
101YP2500X
Professional Counselor
Primary
CTB-2025-0519
NM
Other
Enumeration date
04/13/2021
Last updated
08/21/2025
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