Provider Demographics
NPI:1669940276
Name:TORRES, TAYRI N
Entity type:Individual
Prefix:
First Name:TAYRI
Middle Name:N
Last Name:TORRES
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 1:2 PINE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-9513
Mailing Address - Country:US
Mailing Address - Phone:862-371-4741
Mailing Address - Fax:
Practice Address - Street 1:2 PINE CREEK DR
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-9513
Practice Address - Country:US
Practice Address - Phone:862-371-4741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 385H00000X
NJ44SL061644001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No385H00000XRespite Care FacilityRespite Care