Individual
TYRA ANN PELLERIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 COMMON ST STE 500, NEW ORLEANS, LA 70112-2467
(504) 302-1323
Mailing address
5421 LAFAYE ST, NEW ORLEANS, LA 70122-6337
(504) 975-5208
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/14/2017
Last updated
03/14/2017
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