Individual
KATHLEEN TYRAKOSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
337 E VIRGINIA AVE, PHOENIX, AZ 85004-1220
(760) 586-4635
Mailing address
887 S HENRY LN, GILBERT, AZ 85296-1475
(760) 586-4635
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-23423
AZ
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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