Provider Demographics
NPI:1326773755
Name:TRIBBLE, TYLER RAE (MGCS)
Entity Type:Individual
Prefix:MS
First Name:TYLER
Middle Name:RAE
Last Name:TRIBBLE
Suffix:
Gender:F
Credentials:MGCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # R4
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-399-7841
Mailing Address - Fax:216-445-6935
Practice Address - Street 1:9500 EUCLID AVE # R4
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-399-7841
Practice Address - Fax:216-445-6935
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000736TEMP170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS