Individual
DEIDRE L TYGART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC III
Contact information
Practice address
14311 E 4TH AVE, AURORA, CO 80011-8703
(303) 513-9252
Mailing address
7251 E 49TH AVE, COMMERCE CITY, CO 80022-4714
(303) 321-2533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC 0006214
CO
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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