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1780379198
TYRA LAKIA FERGUSON
LONGWOOD, FL
NPI
1780379198
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-04-11
Last Update Date
2023-04-11
Business Address
Ms. TYRA LAKIA FERGUSON MA
651 W WARREN AVE STE 100
LONGWOOD, FL 32750-4036
Phone number: 786-306-0177
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Mailing Address
Ms. TYRA LAKIA FERGUSON MA
1454 SUNSHADOW DR APT 100
CASSELBERRY, FL 32707-9001
Phone number: 786-306-0177
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