DESTINEE G TYRA

RUSSELLVILLE, AR
NPI1457087553
Former NameDESTINEE PENZO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: AR  A2602002)
Enumeration Date2022-07-29
Last Update Date2026-02-20
Business Address
DESTINEE G TYRA LAC
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-968-1298
Mailing Address
DESTINEE G TYRA LAC
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-968-1298
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