Provider Demographics
NPI:1275257016
Name:ORMOND, TYRECIA
Entity Type:Individual
Prefix:
First Name:TYRECIA
Middle Name:
Last Name:ORMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 FAYETTEVILLE RD STE 116
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6254
Mailing Address - Country:US
Mailing Address - Phone:919-480-2800
Mailing Address - Fax:
Practice Address - Street 1:6015 FAYETTEVILLE RD STE 116
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6254
Practice Address - Country:US
Practice Address - Phone:919-480-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician