Individual provider · Type 1 NPI
Tyra Louise Anderson
Specialist · East Point, GA
NPI number
1417448432
Active
Practice location
1514 Cleveland Ave Ste 103-5
East Point, GA 30344-6965
Mailing address
858 Amberwood Way
Forest Park, GA 30297-4256
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 1744P3200X (GA) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
About NPI 1417448432
Tyra Louise Anderson's National Provider Identifier is 1417448432, issued on May 24, 2018. The primary taxonomy on file is Specialist (174400000X), and the practice location is in East Point, GA. The record was last updated on Jun 16, 2018.