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General NPI Number Information
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NPI Number | 1972197432
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Entity Type | Individual
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Provider Name | KYRA TULEY LCSW, TCADC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 5966 SCOTTSVILLE RD
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City | BOWLING GREEN
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State | KY
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Zip | 42104-0387
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Country | US
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Telephone | 270-904-5104
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Fax | 270-201-5980
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Provider Business Mailing Address
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Address Line | 4208 STARK ST
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City | MURFREESBORO
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State | TN
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Zip | 37129-1499
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 257847
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8794
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License Number State | TN
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