Individual
TYRA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 RICE TERRACE DR, COLUMBIA, SC 29229-9377
(803) 206-5910
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-70434
—
Other
Enumeration date
01/15/2019
Last updated
02/27/2023
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