Individual
DIANE S TYRRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5500 MAIN ST, SUITE 207, WILLIAMSVILLE, NY 14221
(716) 633-6900
(716) 633-6902
Mailing address
5500 MAIN ST, SUITE 207, WILLIAMSVILLE, NY 14221
(716) 633-6900
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009444-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000510515001
HEALTH NOW
NY
Enumeration date
09/08/2005
Last updated
07/10/2015
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