Provider Demographics
NPI:1881421287
Name:HENRY, TYRIA
Entity type:Individual
Prefix:
First Name:TYRIA
Middle Name:
Last Name:HENRY
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 1:2714 WADE RD SE APT 302
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5916
Mailing Address - Country:US
Mailing Address - Phone:202-300-0384
Mailing Address - Fax:
Practice Address - Street 1:2714 WADE RD SE APT 302
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5916
Practice Address - Country:US
Practice Address - Phone:202-300-0384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist