Provider Demographics
NPI:1043556913
Name:CYRA, TAMMY CAMILLE (LCDC)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:CAMILLE
Last Name:CYRA
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9555 LEBANON RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6095
Mailing Address - Country:US
Mailing Address - Phone:469-362-8004
Mailing Address - Fax:469-362-8515
Practice Address - Street 1:9555 LEBANON RD
Practice Address - Street 2:SUITE 301
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6095
Practice Address - Country:US
Practice Address - Phone:469-362-8004
Practice Address - Fax:469-362-8515
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10022101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)