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Individual

TYRA DODD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
11110 BOARDWALK DR APT 28, BATON ROUGE, LA 70816-8394
(225) 266-0188
Mailing address
11110 BOARDWALK DR APT 28, BATON ROUGE, LA 70816-8394
(225) 266-0188

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3806
LA

Other

Enumeration date
03/11/2014
Last updated
03/11/2014
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