Individual
TYRA MCRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12308 BREAPHITT CT, TAMPA, FL 33626-2695
(561) 501-0998
Mailing address
5005 W LAUREL ST STE 100, TAMPA, FL 33607-3896
(561) 501-0998
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
240586
FL
251S00000X
Community/Behavioral Health Agency
240878
FL
251S00000X
Community/Behavioral Health Agency
240937
FL
Other
Enumeration date
08/28/2017
Last updated
09/16/2025
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