Individual
TYRA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 W EAGER ST STE 200, BALTIMORE, MD 21201-5469
(410) 622-5887
Mailing address
10 W EAGER ST STE 200, BALTIMORE, MD 21201-5469
(410) 622-5887
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
916788
—
MD
Enumeration date
06/20/2019
Last updated
08/31/2023
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