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Tyera Nicole Godfrey
Mental Health Counselor in Malden, Massachusetts
NPI 1871083246

Tyera Nicole Godfrey is a Mental Health Counselor based in Tewksbury, MA and is specialized in Mental Health. Tyera Nicole Godfrey practices in Malden, MA. The NPI Number for Tyera Nicole Godfrey is 1871083246 and holds a License No. (Massachusetts).

The current practice location address for Tyera Nicole Godfrey is 12 Perkins Ave, Malden, MA and can be reached out via phone at 781-630-3254.

Location: 12 Perkins Ave, Malden, MA, 01876-3305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871083246
Provider Name
Tyera Nicole Godfrey
Credential
Provider Entity Type
Individual
Gender
Female
Address
12 Perkins Ave, Malden, MA, 01876-3305
Phone Number
781-630-3254
Fax Number
Provider Enumeration Date
05/11/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6584664000 05 MA
1125488448 05 MA
institution
Provider Business Practice Location Address Details
Address
12 Perkins Ave
City
Malden
State
Massachusetts
Zip
02148-7502
Phone Number
781-630-3254
Fax Number
person
Provider Business Mailing Address Details
Address
12 Perkins Ave
City
Malden
State
Massachusetts
Zip
02148-7502
Phone Number
781-630-3254
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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