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Individual

TIFFANY JEAN TYREE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4702 LEONARD BLVD S, LEHIGH ACRES, FL 33973-6157
(239) 219-4254
Mailing address
4702 LEONARD BLVD S, LEHIGH ACRES, FL 33973-6157
(239) 219-4254

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
22000078219
FL
376J00000X
Homemaker
Primary
22000078219
FL

Other

Enumeration date
02/24/2022
Last updated
02/24/2022
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