Individual
DR. TYRA WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
5080 LE CHATEAU COVE, OPTIONAL, MEMPHIS, TN 38125-0267
(901) 921-6566
(888) 551-0262
Mailing address
5080 LE CHATEAU CV, MEMPHIS, TN 38125-3912
(901) 921-6566
(888) 551-0262
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5879
TN
225400000X
Rehabilitation Practitioner
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q08224
—
TN
Enumeration date
04/25/2013
Last updated
12/04/2024
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