Individual
MR. REGINALD WAYNE TYREE II II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.S.
Contact information
Practice address
310 S BRIDGE ST, BEDFORD, VA 24523-2706
(540) 586-1045
Mailing address
310 S BRIDGE ST, BEDFORD, VA 24523-2706
(540) 586-1045
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813001115
VA
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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