Individual
TYLER THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRPA-T
Contact information
Practice address
201 E GREEN ST, ITHACA, NY 14850-5635
(607) 274-6288
Mailing address
201 E GREEN ST, ITHACA, NY 14850-5635
(607) 274-6288
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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