Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0133001705 | VA |
NPI | 1003437864 |
---|---|
Provider Name | Rachel Tyree |
First Address | Richmond, VA 23228-2368 |
Second Address | Richmond, VA 23294-3638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2020 |
Last Update Date | 04/05/2020 |