Provider Demographics
NPI:1083149165
Name:JOSEPH, TYRANIKA
Entity Type:Individual
Prefix:MS
First Name:TYRANIKA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TYRANIKA
Other - Middle Name:DONYALL
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 BARROW ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4764
Mailing Address - Country:US
Mailing Address - Phone:985-303-0182
Mailing Address - Fax:985-303-0181
Practice Address - Street 1:801 BARROW ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4764
Practice Address - Country:US
Practice Address - Phone:985-303-0182
Practice Address - Fax:985-303-0181
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator