Tyria Jeannine Thaxton

NPI #1033860242 in Detroit, Michigan

Provider Information

NPI Number: 1033860242
Entity Type: Individual
Name: Tyria Jeannine Thaxton
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 10, 2022
Last Updated: Jan 13, 2022

Practice Location

Address: 7375 WOODWARD AVE STE 2800
City: Detroit
State: Michigan
ZIP Code: 48202-3157
Phone: (888) 922-2843

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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