Provider Demographics
NPI:1609699636
Name:WASHINGTON, TYRIANNA (BS)
Entity type:Individual
Prefix:
First Name:TYRIANNA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 FRONT STREET
Mailing Address - Street 2:
Mailing Address - City:CHENEYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71325
Mailing Address - Country:US
Mailing Address - Phone:318-308-2820
Mailing Address - Fax:
Practice Address - Street 1:217 BREVARD CT
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3996
Practice Address - Country:US
Practice Address - Phone:318-445-9019
Practice Address - Fax:318-445-1098
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator