Provider Demographics
NPI:1659095602
Name:TNR LLC
Entity Type:Organization
Organization Name:TNR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYD, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEG
Authorized Official - Middle Name:
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-567-4063
Mailing Address - Street 1:2520 N UNIVERSITY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3819
Mailing Address - Country:US
Mailing Address - Phone:385-567-4063
Mailing Address - Fax:
Practice Address - Street 1:2520 N UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3819
Practice Address - Country:US
Practice Address - Phone:385-567-4063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty