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Tyra Louise Anderson
Specialist in East Point, Georgia
NPI 1417448432

Tyra Louise Anderson is a Specialist based in Forest Park, GA. Tyra Louise Anderson practices in East Point, GA. The NPI Number for Tyra Louise Anderson is 1417448432 and holds a License No. 1744P3200X (Georgia).

The current practice location address for Tyra Louise Anderson is 1514 Cleveland Ave Ste 103-5, East Point, GA and can be reached out via phone at 770-256-7221.

Location: 1514 Cleveland Ave Ste 103-5, East Point, GA, 30297-4256
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417448432
Provider Name
Tyra Louise Anderson
Credential
Provider Entity Type
Individual
Gender
Female
Address
1514 Cleveland Ave Ste 103-5, East Point, GA, 30297-4256
Phone Number
770-256-7221
Fax Number
Provider Enumeration Date
05/24/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
825455207 01 GA DEPARTMENT OF TREASURY INTERNAL REVENUE SERVICE
institution
Provider Business Practice Location Address Details
Address
1514 Cleveland Ave Ste 103-5
City
East Point
State
Georgia
Zip
30344-6965
Phone Number
770-256-7221
Fax Number
person
Provider Business Mailing Address Details
Address
1514 Cleveland Ave Ste 103-5
City
East Point
State
Georgia
Zip
30344-6965
Phone Number
770-256-7221
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
1744P3200X (Georgia)
Definition
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.
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