Individual
TYRRELL CARBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
946 E 211TH ST, BRONX, NY 10469-1108
(718) 547-0133
(718) 547-0051
Mailing address
946 E 211TH ST, BRONX, NY 10469-1108
(718) 547-0133
(718) 547-0051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26470
NY
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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